Recertification Application – Florida Police Accreditation Coalition

To be considered for recertification:

Mandatory requirements must be met and are described throughout the application.
No points are awarded for meeting mandatory requirements.
Candidates MUST be active, which means recent activity in assignments, assessments, and training, and attendance at conferences and business meetings.
The candidate’s agency MUST be a current active member, or the applicant MUST be a retiree member of the FLA-PAC.
Candidates must tally the points they are requesting in the “Total Points” column where indicated (please use a calculator). Verification of point totals will be made by the CAP Committee.
For points to be awarded based on committee membership, written verification must be received from the committee chair stating the candidate was an active and contributing member.
For points to be awarded based on being a committee chair, written verification must be received from the FLA-PAC President stating the candidate was an active and contributing member.

Deadline for submitting application is six (6) weeks prior to the next scheduled conference. Check the FLA-PAC website for dates. The minimum number of points required to earn recertification is 200.

CAP: Recertification Application

"*" indicates required fields

Step 1 of 9

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Personal Information

Name*

Last

Date of CAP Initial Certification*

MM slash DD slash YYYY

Recertification Date

MM slash DD slash YYYY

Recertification Date

MM slash DD slash YYYY

Recertification Date

MM slash DD slash YYYY

Recertification Date

MM slash DD slash YYYY

Recertification Date

MM slash DD slash YYYY

Recertification Date

MM slash DD slash YYYY

Applicant is*

Current, active member of FLA-PAC

Retiree member of FLA-PAC

Name*

First Middle Last

Rank/Position/Title*

Current/Former Employing Agency*

Agency Address*

Street Address City State / Province / Region ZIP / Postal Code

Work Phone*

Work Email*

Fax

Optional Information

Home Address

Street Address City State / Province / Region ZIP / Postal Code

Home Phone

Personal Email

Preference(s)

If you need to be contacted

Phone*

Work

Home

Mailing*

Work

Home

Email*

Work

Home

Name as you wish it to appear on certification credentials*

Current/Former agency is current member of FLA-PAC*

Yes

Accredited Agency Information

1) This section identifies the candidate’s employing agency while assigned to accreditation activities; and 2) This may or may not be the same agency listed in the preceding section.

Agency*

CEO*

Title*

Address*

Street Address City State / Province / Region ZIP / Postal Code Country

Agency Phone*

Candidate was assigned to Accreditation activities during Accreditation/Re-Accreditation*

Yes

Date of Accreditation/Re-Accreditation*

MM slash DD slash YYYY

Type*

Mandatory Requirements

1) Attendance of one (1) FLA-PAC conference AND attendance at one (1) FLA-PAC business meeting during the preceding three (3) years certification period is required; and 2) DO NOT list location of the conference – provide the date.

FLA-PAC Conference Attendance*

MM slash DD slash YYYY

FLA-PAC Business Meeting Attendance*

MM slash DD slash YYYY

Last Name*

Last

Mandatory Requirements – Active Assessor

The candidate must meet the following mandatory requirement to be considered an “Active Assessor”: A minimum of three (3) assessments during the three (3) year certification period – preferably one (1) per year. ACTIVE ASSESSOR: (Three assessments during the certification period. This is a mandatory minimum requirement. No points are awarded for these assessments.)

Agency

Date

MM slash DD slash YYYY

Type

Agency

Date

MM slash DD slash YYYY

Type

Agency

Date

MM slash DD slash YYYY

Type

Additional Assessments/Technical Visits/Mentoring: Assessments beyond the mandatory minimum.

Active Assessor or Team Leader: (Additional Assessments – 25 points awarded each assessment)

Agency 1

Date

MM slash DD slash YYYY

Type

Please Select

Assessor

Team Leader

Points for Agency 1

Agency 2

Date

MM slash DD slash YYYY

Type

Please Select

Assessor

Team Leader

Points for Agency 2

Agency 3

Date

MM slash DD slash YYYY

Type

Please Select

Assessor

Team Leader

Points for Agency 3

Technical Assistance Visits: (Technical Visits/File Reviews – 15 points awarded each visit)

Agency

Date

MM slash DD slash YYYY

Points

Agency

Date

MM slash DD slash YYYY

Points

Agency

Date

MM slash DD slash YYYY

Points

Mentorship: (25 points awarded for each agency mentored)

Agency

Date

MM slash DD slash YYYY

Points

Agency

Date

MM slash DD slash YYYY

Points

Agency

Date

MM slash DD slash YYYY

Points

Total Combined Points for this Section

Education/Training: Points – Maximum 100 Only education/training received during the most recent certification period (three years) may be listed.

Re-Accreditation Workshop: Organization Presenting: (10 points awarded)

Organization Presenting

Date

MM slash DD slash YYYY

Points

Assessor Training: (25 points awarded)

Organization Presenting

Date

MM slash DD slash YYYY

Points

Team Leader Training: (25 points awarded)

Organization Presenting

Date

MM slash DD slash YYYY

Points

Total Combined Points for this Section

FLA-PAC Conference Training Classes

Course Title

Date

Points

(10 points each course)

Training Courses presented by Accrediting Organizations other than FLA-PAC (ACA / CALEA / CFA / FCAC / FL-TAC, etc.)

Course Title

Date

Points

(10 points each course – courses must be completed during re-certification period)

Additional Training

Course Title

Date

Points

(1 point each documents hour) (Instructions for this section: 1) Must be related to accreditation, such as staff inspections, policy development, planning and research, etc.; 2) Emergency management, patrol operations, investigations, etc. are not applicable; 3) Documented hours must be listed on certificates, rosters, class literature, etc; and 4) Training listed on prior CAP applications CANNOT be used for recertification. Only education/training received during the most recent certification period (three years) may be listed.)

Total Combined Points For This Section

Section Additional Commission Meetings

Points – Maximum 75

Attendance at Commission Meetings:

Commission

Date

Points

(ACA / CALEA / CFA / FCAC / FLA-TAC) (25 points each meeting)

Total Points For This Section

Additional FLA-CAP Conferences/Business Meetings

Points – Maximum 75

FLA-PAC Conference Attendance:

Conference Location

Date

Points

(25 points each conference)

Total Points This Section

FLA-PAC Business Meeting Attendance:

Confrence Location

Date

Points

(25 points each meeting)

Total Points This Section