Food Jobs Work Adult Culinary Program is a 12-week course for adults with barriers to employment. After training, our goal is to place you into full-time employment or apprenticeship in the culinary industry. The course is offered at no cost to you.

Students must be referred from a social worker, peer support specialist, or similar non-relative case manager with a letter verifying the person’s reliability, sobriety (at least 3 months), and access to housing and transportation. If you have a case manager, please have their name, phone number, and email before starting the form.

You will be contacted with next step instructions if chosen for an interview. Please complete this form to be considered!

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Have you had any circumstances that made employment difficult, such as past incarceration or other justice involvement, addiction, homelessness or near homelessness, abuse, poverty, or other barriers? (You do not have to tell us details.) *

• Yes
• No

Food Jobs Work is intended for adults with barriers to employment. While you do not qualify at this time, please stay connected with us as we grow. In the future we will have self-pay options for individuals without these barriers.

Do these challenges include a physical or psychiatric diagnosis? This can include diabetes, depression, or ADHD. (You do not have to tell us details.) *

• Yes
• No

Full Name *

First

Last

City Where You Live *— Select Choice —BentonBryantConwayJacksonvilleLittle RockMaumelleNorth Little RockPine BluffSherwoodOther

Write In Your City:

Email Address *

Phone Number *

Date of Birth *

Social Security Number (for federal grant reporting)

Referring Organization / Where you have case management *Arkansas Rehabilitation Services (ARS)Arkansas Workforce Center at Little Rock (S. University)Freshly Renewed TransitionalGoodwill ArkansasJericho WayNatural State RecoveryNext Step Recovery HousingOur HouseWolfe Street FoundationOther LocationNone – I need a referral

Please write in location for case management

Name of Case Manager / Peer Support Specialist *

Email of Case Manager / Peer Support Specialist *

Phone Number of Case Manager / Peer Support Specialist *

Which cohort would you like to join?

• Little Rock – July-Sept 2026
• Pine Bluff – Oct.-Dec. 2026
• Online Training (Incarcerated adults)
• Little Rock – Future Cohort
• Pine Bluff – Future Cohort
• Northwest Arkansas – Future Cohort
• Hot Springs – Future Cohort

This program requires a serious commitment of time and attendance. If accepted, will you be available on Monday through Thursday, 9 a.m. to 5 p.m. through the entire 12-week program? *

• Yes
• No

Explain your answer: *

Are you currently employed? *

• Yes
• No

will Size Manager

Will you be able to adjust your schedule, if necessary, to evenings Monday through Friday, and weekends only during the course? Add details if needed. *

Why do you want to join the Food Jobs Work culinary program? *

Tell us about your prior cooking or restaurant experience. Home cooking is okay! *

Do You Prefer Male or Female Clothes Sizing? *

• Male
• Female

T-Shirt Size (unisex sizing) *Extra SmallSmallMediumLargeExtra Large2X3X

Pants Waist

Selected Value: 35

Pants Size

Selected Value: 16

Blouse Size

Selected Value: 16

Chest Measurement

Selected Value: 42

Questions or Comments

To keep the bots out: *

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