"*" indicates required fields Agency Name*Head of Agency InformationHead of Agency* First Last Head of Agency Title*Head of Agency Email* Head of Agency Phone*Agency heads are highly encouraged to attend the Accreditation Program Manager class but only the familiarization training is required. Has the current agency head at least completed the familiarization training? Yes No Method*Date of training, if yes.* MM slash DD slash YYYY Accreditation Program ManagerAccreditation Program Manager* First Last Accreditation Program Manager TitleAccreditation Program Manager Email* Accreditation Program Manager Phone*Has the current program manager completed the required Accreditation program training class? Yes No Date of Class MM slash DD slash YYYY Class LocationSignatureThis memorandum confirms that I am aware of the existing contract between the above-named agency and the Texas Police Chiefs Association Foundation (TPCAF), and I affirm my intent to remain in full compliance with all applicable accreditation standards. I also acknowledge that maintaining membership in the Texas Police Chiefs Association is a requirement of accredited status. My membership is currently active and in good standing.Head of Agency Digital Signature*Today's Date* MM slash DD slash YYYY Δ
