Annual Directors Conflict of Interest Policy Form

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Annual Directors Conflict of Interest Policy Form

All members of the AvaCon Executive Board, Officers, and Directors are required to annually review the AvaCon Conflict of Interest Policy and complete the form below.

 

I affirm that I have received a copy of the AvaCon, Inc. Annual Directors Conflict of Interest Policy.
I affirm that I have read and understand the AvaCon, Inc. Annual Directors Conflict of Interest Policy.
I affirm that I agree to comply with the AvaCon, Inc. Annual Directors Conflict of Interest Policy.
I affirm that I understand AvaCon, Inc. is a charitable organization and in order to maintain its federal tax exemption, it must engage primarily in activities which accomplish one or more tax-exempt purposes.
Do you have a financial interest (current or potential), including a compensation arrangement, that would be in conflict as defined in the Conflict of Interest policy with AvaCon, Inc.?
If yes above, please explain.
In the past have you had a financial interest, including a compensation arrangement, that would be in conflict as defined in the Conflict of Interest policy with AvaCon, Inc.?
If yes above, please explain.
By entering your first and last name in the text box, you indicate that you are electronically signing this document and all statements are true and accurate to the best of your knowledge. You further agree that any misrepresentation, false statement, or omission, made by you with respect to the information contained in this submission shall be sufficient cause to terminate your employment, membership, or sufficient cause to remove you from any Office or position of authority with AvaCon, Inc.