C I V P O L   P R O G R A M   I R A Q  

P r o g r a m   M a n a g e m e n t   O f f i c e    

C a m p   K l e c k e r  

B a g h d a d ,   I r a q  

 

_________________________________________________________________________________________________________ 

 

CPATT/DynCorp - Camp Klecker, Unit No 43149 - APO AE 09344 3149 

_________________________________________________________________________________________________________ 

 

 

Policy Receipt Acknowledgement 

 

 
CIV 3201 
Media Relations and Confidentiality Policy 
Effective Date:  1 November 2006 
Revised Date: 20 October 2007 

 
 
 
I  ___________________________________ , 

employee  ID number _______________, assigned  to  the  DI  

  

 

Print Name   

 

 

 

 

                Clock Number 

CIVPOL Iraq program as of the date below, hereby certify that: 
 

 

1.   I have received a copy of, and have read the CIVPOL Media Relations and Confidentiality Policy, 

effective date 1 November 2006, with a revision date of 20 October 2007.  

 

2.  I understand that if I have questions, at any time, regarding the CIVPOL Media Relations and 

Confidentiality policy, I will consult with my immediate Supervisor or my Human Resources staff 

members. 

 

3.   I agree to comply with the CIVPOL Media Relations and Confidentiality Policy and will immediately 

report through my Supervisor all instances of which I become aware the CIVPOL Media Relations 

and Confidentiality Policy appears to have not been followed; 

 

and 

 

4.   I acknowledge that any failure to fully comply with the CIVPOL Media Relations and Confidentiality 

Policy may result in disciplinary action up to and including termination, without the necessity of my 

receiving any prior warning or second chance. 

 
 

 

__________________________________ 

    _________________ 

Employee 

Signature       Date 

 
 

__________________________________ 

    

Employee 

Name 

(Print)