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Chief’s Advisory Panel Application
Applicant Information
First Name
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Last Name
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Date of Birth
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Drivers License Number
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Current Address
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E-mail
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Phone Number
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Employment Information
Current Employer
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Employer Address
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Employer Phone Number
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Position
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Chief’s Advisory Panel Questionnaire
1) How did you hear about the Chief's Advisory Panel?
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2) Explain why you are interested in serving on the Chief’s Advisory Panel.
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3) Summarize any experience, knowledge or skills that would be relevant to your participation as a Chief’s Advisory Panel member.
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4) How will you gather input regarding community needs?
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5) If selected, how will you increase the community's awareness of public safety issues and further the overall effectiveness of the Chief’s Advisory Panel?
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6) Describe topics you would like addressed by the CAP.
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7) Describe your past and current involvement in the Pleasant Hill community including participation with any boards, non-profits, committees, or local organizations (i.e., PTA, Service Clubs, Faith-Based Organizations, etc.).
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8) Describe how your perspectives will be beneficial to the Chief’s Advisory Panel and the Pleasant Hill community?
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9) Have you had any contact with the Pleasant Hill Police Department? If yes, please describe.
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By initialing this application, you agree that all information is correct and that you are allowing the Pleasant Hill Police Department to do a criminal background check.
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