CJIS Security Awareness Training Compliance Acknowledgement Form
Use this form to confirm completion of security awareness training and acknowledge your responsibility to follow required security practices for handling sensitive criminal justice information.
Trainee Information
Trainee’s Full Name
*
First Name
Middle Name
Last Name
Job Title / Role
*
Department / Unit
*
Organization / Agency Name
*
Work Email Address
*
example@example.com
Phone Number for Follow-up
Please enter a valid phone number.
Format: (000) 000-0000.
Training Completion Details
Training Completion Date
*
-
Month
-
Day
Year
Date
Training Method or Delivery Format
*
In-person
Online/Self-paced
Instructor-led Virtual
Other
Training Course / Module Name
*
Trainer / Instructor Name
Certificate or Completion Reference Number
Security Responsibilities Confirmation
Protect confidential criminal justice information
*
Yes
No
Use information only for authorized work
*
Understood
Not understood
Keep access credentials confidential and never share them
*
Agree
Disagree
Security practices you will follow when your workstation is unattended
*
Lock the screen
Log off or sign out
Secure physical documents
Shut down the workstation
Other
If you suspect a security incident, what will you do?
*
Report it immediately
Notify a supervisor
Preserve evidence and details
Wait until the end of the day
Other
Supervisor or Administrative Review
Reviewer Name
*
Reviewer Role/Title
*
Review Date
*
-
Month
-
Day
Year
Date
Training Completion Verified
*
Yes
No
Submit Acknowledgement
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