stateofcalifornia–departmentofjustice.docVIP

State of California – Department of Justice TEAM BUILDING WORKSHOP – APPLICATION POST 2-113 (Rev 12/2012) Commission on Peace Officer Standards and Training (POST) 860 Stillwater Road, Suite 100 West Sacramento, CA 95605-1630 INSTRUCTIONS Use this form to apply for approval to hold a POST-reimbursed Team Building Workshop. Applications will be accepted on or after May 1st each year. Use the additional space provided at the end of this form to complete your comments as needed. Submit the completed and signed application to the above address, or fax the application to POST at 916 227-0195. Applications are processed on a first-come, first-served basis. You will be contacted after your application has been reviewed. SECTION 1. AGENCY INFORMATION 1. AGENCY NAME 2. AGENCY OR DEPARTMENT HEAD 3. AGENCY PHONE ( ) 4. ADDRESS Street City CA Zip 5. AGENCY CONTACT NAME 6. RANK / CLASSIFICATION 7. CONTACT PHONE ( ) SECTION 2. SCOPE OF WORKSHOP (Continue comments on page 3 if additional space is needed) 8. DESCRIBE THE TOPICS THAT WILL BE COVERED 9. THIS WORKSHOP IS INTENDED TO PRODUCE THE FOLLOWING RESULTS 10. EXPLAIN WHY THIS WORKSHOP IS NECESSARY TO ACCOMPLISH THE ABOVE RESULTS SECTION 3. ATTENDEES 11. THE FOLLOWING INDIVIDUALS WILL PARTICIPATE IN THE PROPOSED WORKSHOP* Full Name Rank Full Name Rank 1) 11) 2) 12) 3) 13) 4) 14) 5) 15) 6) 16) 7) 17) 8) 18) 9) 19) 10) *POST reimbursement is limited to a maximum of 19 participants. SECTION 4. PAST WORKSHOPS (Continue comments on page 3 if additional space is needed) 12. IDENTIFY THE LAST POST-CERTIFIED TEAM BUILDING WORKSHOP AND DATE PRESENTED Date of Most Recent Workshop No Prior Team Building Workshop 13. THE FOLLOWING ACTIONS HAVE RESULTED FROM THE ABOVE POST WORKSHOP SECTION 5. ATTESTATION 14. AUTHORIZED BY AGENCY HEAD I request approval for a POST-certified Team Building