CPOA Peace Officers' Association Board of Directors Candidate Information Form

Office for Consideration
2nd Vice President 3rd Vice PresidentTreasurerDirector at Large

Name/Rank of Candidate

Employee/Address:


Contact Number

Email

Educational Preparation
(include degree, date, place):

Past Participation in California Peace Officers' Association
(membership, region level activity, state level activity):

Participation in other professional organizations:

Qualifications for Office:

What skill sets/specialties do you bring to the table that would benefit the membership of CPOA?

State briefly why you wish to run for office:

I have read and understand the board position descriptions/criteria and the board agreement forms.
I believe I am qualified for, and if elected, I am willing to accept the responsibilities of this position.
I am aware of, and can commit to, the financial obligations of Board participation.

Signature of Nominee (Type your name to accept):

Name of individual nominating this candidate (if not candidate)

I have contacted this candidate:

References Form

I further consent to the Board Development Committee contacting the following two reference to validate my professional qualifications for this position.

Reference #1

Name

Position

Organization

Address

Phone

Email

Reference #2

Name

Position

Organization

Address
Phone

Email