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Please list two references that are knowledgeable about your skills and perspectives related to serving on the Chief's Advisory Committee.

I certify that the statements made by me in this application are true, complete and correct to the best of my knowledge and belief, and are made in good faith. I understand that falsification, misrepresentation or omission of facts called for by the application could result in immediate dismissal in this program.

I authorize the City of Dixon the right to contact and obtain information from all references, employers, educational institutions, and law enforcement agencies, and otherwise verify the accuracy of the information contained in the application. I hereby release from liability the City of Dixon and its representative from seeking, gathering and using such information and all other person, corporation or organization from furnishing and disclosing information.

I agree to report all contact(s) (e.g. speeding ticket, arrest, etc.) with any law enforcement agency during the course of the Chief's Advisory Committee to the Management Analyst or Lieutenant immediately.