1105-0030 Interview Scheduling Form

OMB No: 1105-0030, Expiration date: 04/30/2022

2021 HONORS PROGRAM VIRTUAL INTERVIEW SCHEDULING SURVEY
(Temporary Travel Survey)

1. Review the information at https://www.justice.gov/legal-careers/honors-program-interviews thoroughly.
2. Submit completed survey by email to DOJHonorsProgram@usdoj.gov with subject line: Last Name, First Name – Interview Scheduling Form
3. DO NOT submit multiple surveys. Contact Liliana Daniel at Liliana.Daniel@usdoj.gov for assistance.
4. If you have a disability or special need that affects your interview, email Deana.Willis@usdoj.gov to request a reasonable accommodation.
5. Interview schedules will be sent to the e-mail address listed on your application. Add mail@avuedigitalservices.com to your contacts to prevent

this information from being sent to a junk or spam mail box.

NAME (as listed on application): _____________________________________________________________
EMAIL (as listed on application):____________________________________________________________________________
SCHEDULING INFORMATION:
Your location between Oct 18 – Nov 5, 2021: City and State/Country: _______________________________________
Your Time Zone between Oct 18 – Nov 5, 2021: _________________________________________________________
•

If outside the continental United States, provide the information below to assist us in scheduling:
8:00 a.m. Eastern Daylight Time (Washington, D.C.) on 10/18/2021 would be_______________ (specify a.m. or
p.m.) on ______________________ (date) where I am located.

INTERVIEW DATES:

List all dates between October 18 and November 5, 2021 that you are unavailable for interviews. Once interviews are
scheduled, we will not reschedule except in case of emergency or DOJ error.
I am unavailable to interview on: ____________________________________________________________________

Preferred Interview Days: Rank in order of preference up to five dates, “1, 2, 3, 4, 5”. There are 15 possible

interview days as listed below. We will try to accommodate your request, subject to availability. Note: The MPRE is
on November 4 or 5, 2021.
Review https://www.justice.gov/legal-careers/honors-program-interviews for component availability restrictions
before listing your top five preferred dates.
Day 1 – Oct 18: ____
Day 2 – Oct 19: ____
Day 3 – Oct 20: ____
Day 4 – Oct 21: ____
Day 5 – Oct 22: ____

Day 6 – Oct 25: ____
Day 7 – Oct 26: ____
Day 8 – Oct 27: ____
Day 9 – Oct 28: ____
Day 10 –Oct 29: ____

Preferred Interview Time: ___ Morning

___ Afternoon

Day 11 – Nov 1: ____
Day 12 – Nov 2: ____
Day 13 – Nov 3: ____
Day 14 – Nov 4: ___
Day 15 – Nov 5: ___
___ No Preference

If there are matters we should consider when scheduling, provide specific details below.

List each hiring component or office that selected you for an interview (including section/branch/city, as appropriate).
If selected by multiple sections/branches within a single component, list each separately (e.g., Civil Division – Fed
Programs; EOIR-OCIJ; Tax-Criminal). A complete list of participating components is at https://www.justice.gov/legalcareers/honors-program-participating-components.
1. ____________________________ 2. __________________________

3. _____________________________

4. _____________________________ 5 ___________________________ 6._____________________________
7. _____________________________ 8.___________________________ 9. _____________________________

[ ] Statement of Agreement

During the 2021 Attorney General’s Honors Program, the U.S. Department of Justice (DOJ) will conduct interviews via virtual platforms,
including but not limited to Microsoft Teams, Skype for Business, and Webex. By accepting a virtual interview with DOJ, I expressly agree
not to record, maintain, use, share, or distribute any part of the interview(s), including materials provided to me during the course of the
interview(s). I acknowledge that violation of this agreement may result in a revocation of any additional interviews or conditional offers of
employment at DOJ.

Signature: _____________________________________________________ Date: ___________
PRIVACY ACT STATEMENT. The following information is provided pursuant to the Privacy Act of 1974, 5 U.S.C. § 552a(e)(3): This
form requests personal information that is relevant and necessary to schedule interview(s) with the U.S. Department of Justice
(DOJ) components and individuals participating in the Attorney General’s Honors Program.
The Office of Attorney Recruitment and Management (OARM) collects this information in order to prepare interview
invitations, provide candidates with information required to establish links to virtual interviews, to schedule both in-person and
virtual interviews, to prepare any travel authorization forms, and to schedule required commercial travel. For virtual interviews,
this information is required to enable access to telephone, video, or web conferencing applications used by DOJ, as well as to
enhance the virtual interview experience by utilizing features and functionality that facilitate information sharing and crossfunctional participation. Facilitation of information sharing, and cross-functional participation may include, but is not limited
to, utilization of the chat feature, along with sharing personal information via your device’s camera and speakers, to enable
virtual face-to-face conversations. For in-person interviews, when appropriate, this information is used to schedule
interview(s) and travel to Washington, D.C., or other locations. OARM has the authority to request and collect this information
pursuant to 5 U.S.C. § 301 and 28 C.F.R. Part 0.15(b)(2).
Any information that you provide may be disclosed pursuant to a “routine use” under the Privacy Act of 1974, 5 U.S.C. § 552a,
as published in the OPM/GOVT-1 System of Records Notice, titled General Personnel Records, 71 Fed. Reg. 35342, as modified
by 77 Fed. Reg. 73694. To review applicable routine uses under OPM/GOVT-1 please visit: https://www.opm.gov/informationmanagement/privacy-policy/sorn/opm-sorn-govt-1-general-personnel-records.pdf.
Your disclosure of information to OARM on this form is voluntary because accepting an interview with the DOJ is a voluntary
action. You are not required to provide any personal information; but if not provided, then you will not be able to participate
in virtual or in-person interviews. Failure to provide information necessary to schedule both virtual and in-person interviews
may result in forfeiting your interview altogether or any government-funded travel and reimbursement of travel costs
associated or incurred during the interview process.