2012 Joe Harper Scholarship Application

CCPOA Membership Application Form

Use this form to apply for membership in the California Correctional Peace Officer's Association. Second form for CCPOA Retired Chapter is included below.  The CCPOA form and the CCPOA Retired Chapter form were both updated on December 13, 2011.

Remember: Flu Vaccinations Are Optional!

It's that time of year again, when we are hit with the decision "To Vaccinate against the Flu" or "Not".  The signs are posted everywhere: Walmart, Walgreens, Costco, Target and CDCR. Unlike your local retail establishment who has the choice whether to offer flu vaccinations to their patrons, CDCR is mandated by Title 8, Section 5199 to offer all of their employees free seasonal flu vaccinations...

CCPOA Travel Expense Form

Use this form to claim gas milage, airline tickets, and all other reimbursable expenses.  (Updated 10/21/2011)

2011 Letters to Santa Golf Tournament

Registration Deadline: October 1, 2011

July 2011 CYA Field Parole Chapter Statewide Meeting

CYA Field Parole Chapter Statewide Meeting

June 2011 Retired Chapter Meeting Form

June 2011 Retired Chapter Meeting Form

CDCR Flu Vaccinations - It’s Optional!

While CDCR is mandated to offer all of their employees free seasonal flu vaccinations, participation in this program is STRICTLY VOLUNTARY and YOU WILL NOT BE DISCIPLINED for declining to get vaccinated, but you MUST fill out one of the attached forms.

CCSO Drop Form

Two forms are included.  One is a blank form that can be printed out and then filled in.  The second form is an interactive .pdf form that can be filled in online and printed out for mailing.

CCPOA’s membership is made up exclusively of Correctional Peace Officers. We do not represent other classifications for a reason - our vision remains focused on the job at hand, enhancing the Correctional Peace Officer series.

A promotion doesn’t mean you need to leave the organization that has the tried and true record of enhancing the working conditions and benefits of all California Correctional Peace Officers. Join us as we continue to set the standard.

After completing this prepaid postage form, fold along the dashed lines, tape it shut and drop it in the mail. CCPOA will see that it is properly delivered for you.

Assault Alert Form

Assault Alert Form from CCPOA

Please complete and fax immediately to CCPOA Headquarters
Attn: Nichol Pryde,  (916)372-0633 with a copy of the 837 incident or special incident report

2010 CCPOA Elections Forms & Schedule

Attached please see below for the the Schedule of Elections for Chapters in 2010 for due dates, deadlines and activities within the 2010 CCPOA elections process.

Additionally, the EC Intent to Run form for 2010 is available below, as well as the 2010 Sample Ballots. 

(Updated 9/14/2010)

Notice of Intent to Run For Trustee of the CCPOA Benefit Trust Fund

 The CCPOA Benefit Trust Fund will hold an election for one (1), three (3) year trustee position during the upcoming CCPOA Convention (to be held December 6-7, 2010, at the Rio All-Suite Hotel & Casino, Las Vegas, Nevada.) The term of this office will be from January 1, 2011, through December 31, 2014. 

The election will take place on December 7, 2010. 

The nomination period is now open and will close on October 18, 2010. 

 The duties of a trustee are to assume the fiduciary responsibilities of the Health, Welfare and Benefit Plans available to CCPOA members. Included in these responsibilities is the willingness to learn and apply the principles of ERISA law, business management, accounting and auditing, contemporary health and welfare programs, and negotiations with insurance providers.   

Note: Beginning January 22, 2004, the election, training and educational requirements for this position have changed. Candidates must participate in a debate with other candidates to the assembled delegates at the annual convention. A newly-elected trustee must complete certain training (at Trust Fund’s expense), including education in fiduciary responsibility, HIPAA and privacy requirements, as well as complete the IFEBP New Trustee Training prior to assuming full voting rights on January 1, 2011.

SAMPLE Layoff Letter from the Governor’s Office

Employee Notice of Layoff

Due to the continuing fiscal crisis in the State of California it has
become necessary to reduce civil service positions. This is to notify you
that ______ positions in the classification of __________________________
have been identified for elimination in the __________(Department Name)
____________________. This is considered your final notification
of layoff.

Civil service rules require that the least senior employees in the department receive surplus notices when there is a reduction in the workforce. You have been identified as one of the least senior in your department which means that you face layoff.

You have been designated as surplus and have priority hiring preference for open positions in special funded positions. Your department has submitted an State Restriction Of Appointment (SROA) Scantron Form to the State Personnel Board to give you preference in hiring on the certification process for your classification.

Now that you have been informed of your surplus/SROA status, there are specific things you need to do and keep in mind:

• Read and keep this letter, attach a copy of this letter to your job application form (Std. 678) and take a copy to all State job interviews. This will verify your surplus status to hiring departments.
• Always respond quickly to hiring departments inquiries. If you do not, you surplus/SROA status may be impacted.
• Appear for all scheduled interviews; your eligibility for surplus status will be impacted if you do not.
• Keep your contact information current.
• If you are offered a job for which you qualify, accept it. Otherwise your surplus/SROA status and hiring preference for a job will be in jeopardy.

For more information on the State's surplus/SROA lists and layoffs go to:
www.dpa.ca.gov/personnel-policies/sroa/main.htm.

CCPOA Generic Form

Statewide Meetings Registration Form

Table Negotiations Sign-in Sheet

Table Negotiations Sign In Sheet. 

SOP 16-4 Chapter Delegates Form

Use this form to record the correct list of Chapter Board of Directors. 

Physical Fitness Incentive Pay

Physical fitness incentive pay Annual Physician Certification. This form is to be delivered directly to the Personnel Office by the employee. 

Information Request (Dills Act)

Sample format for an information request

Information Request (California Public Records Act)

This letter is a request under the California Public Records Act, Government Code Section 6250, et seq. for copies of the following identified documents. As such, you must determine whether to comply with this request within 10 days of your receipt of this letter. If you deny this request, you must clearly state the reason for your denial and provide the names and titles or positions of each person responsible for the denial. (Government Code Section 6256.2)

CCPOA Grievance Form

STATE OF CALIFORNIA EMPLOYEE CONTRACT GRIEVANCE

Please refer to your bargaining unit's contract for specific information regarding employee grievance procedures and time frame requirements