CHIEF'S ADVISORS ON PUBLIC SAFETY (CAPS) APPLICATION

CHIEF'S ADVISORS ON PUBLIC SAFETY (CAPS) APPLICATION

Deadline: October 10, 2025
The Chief's Advisors on Public Safety (CAPS) is a forum for police-community interaction that provides information and feedback from a diverse group of community members to the Chief of Police on public safety and quality of Life issues in the Brea community. The CAPS shall be comprised of no more than 10 (ten) persons, who should be representatives of a diverse cross-section of the community, including business leaders, service organizations, faith-based organizations, young adults (age 18-25), high school students, mothers of school-aged child(ren), the Hispanic-American, Asian-American and African-American communities, and the Senior Community. Committee members must live or work in the City of Brea, and will be subject to participation in an interview with the Brea Police Department Command Staff, and a limited background review as detailed below.
Name*

First NameMiddle NameLast Name
Address*

Home Address

Street Address Line 2

CityState

Zip
Date of Birth (MM/DD/YYYY)*

MonthDayYear
Date
Sex*
Race/Ethnicity*
Day Time Contact Number*
Evening Time Contact Number*
E-mail address*
example@example.com
Driver License #*
Employer*
Occupation*
Work Address*

Work Address

Street Address Line 2

CityState

Zip
Work Phone*
In the event of emergency, please contact:
Name*
Phone*
Address*

Address

Street Address Line 2

CityState

Zip
Relationship*
Provide a full response to all questions.
How did you hear about the Chief's Advisors on Public Safety?*
Briefly explain your interest in and qualifications for serving on the Chief's Advisors on Public Safety*
Do you have any current or former involvements with a public or private committee, commission or board? If yes, please list the committee, commission, or board name, your title/role, and a reference.*
Have you had contact or interaction with law enforcement, positive or negative? Negative contacts (arrests, citations, etc.) are not automatically disqualifying.*

YesNo
If you answered yes to the above question, please briefly explain:
Only completed applications will be accepted and reviewed. Please make sure all questions are completed to the best of your knowledge. Applications will be screened on the basis of information submitted with this form.
CERTIFICATION AND PERMISSION TO CONDUCT A LIMITED BACKGROUND REVIEW, INCLUDING A CRIMINAL HISTORY CHECK WITH LOCAL, STATE AND FEDERAL AGENCIES, REVIEW OF DRIVING
HISTORY, AND VERIFICATION OF REFERENCES: As an applicant for the Brea Police Department’s Chief's Advisors on Public Safety Committee, I authorize the Brea Police Department to conduct a criminal history check and verification of my references. I understand that this criminal history check is being conducted due to the sensitivity and confidentiality of the Chief's Advisors on Pubic Safety Committee. I understand that all all matters herein contained and all available police and criminal records will be reviewed and the information will be used in determining eligibility of applicants. By signing and submitting this application, I certify that all information contained herein is true and correct under PENALTY OF PERJURY.

I further understand that all applications are processed on a first-come, first-served, basis and that submittal of an application does not guarantee my acceptance onto the Chief's Advisors on Public Safety Committee.

Applications for the Chief's Advisors on Public Safety Committee will be accepted until October 10, 2025.
Full Name*
Signature*
Date*

MonthDayYear
Date
You may submit this application by selecting the below "Submit" button.
Should be Empty:

CHIEF'S ADVISORS ON PUBLIC SAFETY (CAPS) APPLICATION

CERTIFICATION AND PERMISSION TO CONDUCT A LIMITED BACKGROUND REVIEW, INCLUDING A CRIMINAL HISTORY CHECK WITH LOCAL, STATE AND FEDERAL AGENCIES, REVIEW OF DRIVING

You may submit this application by selecting the below "Submit" button.