Conflict of Interest Disclosure Form
For Volunteers
Full Name
Email
Date
Role(s) or Position(s) with Organization
Do you or any immediate family members have any relationships, positions, interests, or affiliations that could create a conflict of interest with the mission or activities of the organization?
Do you or your immediate family members have a financial interest (ownership, investment, employment, etc.) in any entity that works with or seeks to work with our organization?
Yes
No
If yes, please explain:
Are there any other activities, relationships, or situations you wish to disclose?
Signature