NJSACOP LAW ENFORCEMENT ACCREDITATION COMMISSION GRANT PROGRAM
APPLICATION Agency Name : Agency Address : Street City
Zip
Chief Execu�ve Officer : Phone Number : Email : Accredited Status : Has your department ever been accredited by a state or na�onal accredita�on program ? Y / N Agency Size : Current Number of Sworn Personnel : Number of Authorized Sworn Personnel : Number of Authorized Non-Sworn Personnel :
Please explain your agency ’ s inability to address pursuit of NJSACOP LEAC accredita�on without receipt of this award . ( atach addi�onal document )
Please provide proof of authoriza�on from your jurisdic�on ’ s supervising administrator to pursue accredita�on ( atach addi�onal document ).
Please explain your agency ’ s plan to obtain necessary support and con�nue the pursuing reaccredita�on following the conclusion of NJSACOP LEAC Grant Program award support . ( atach addi�onal document )
I understand that should my agency receive funding through the NJSACOP LEAC Grant Program , my agency is commited to successfully comple�ng the accredita�on process , and I further understand that my agency will be obligated to reimburse the NJSACOP LEAC for all funds received from the NJSACOP LEAC Grant Program if my agency fails to successfully receive NJSACOP LEAC Accredita�on and ini�al NJSACOP LEAC Re-Accredita�on .
Agency Name : Agency Chief Execu�ve : Signature : Date :
Please complete the form , and forward with all appropriate atachments to : NJSACOP Law Enforcement Accredita�on Commission , 751 Route 73 North , Suite 12 , Marlton , NJ 08053
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