Police Chief's Citizen Advisory Board
Street Address Line 2
State / Province
Postal / Zip Code
Home Phone Number
Other Phone Number
Place of Employment
Do you reside in the City Limits?
Why are you interested in serving on the Chief's Advisory Board?
Tell us about your interest, skills, education, areas of expertise and professional organizations that you feel would be of assistance as a member of the CAB
Has any formal charge of professional misconduct ever been sustained against you in any jurisdiction?
If yes, please explain complete disposition:
Is there any possible conflict of interest or other matter that would create problems or prevent you from fairly and impartially discharging your duties as a member of the CAB?
If yes, please explain conflict:
Should be Empty: