Sorry. You must be logged in to view this form.
conflict of Interest form 3 sign
NORTH CENTRAL WV COMMUNITY ACTION ASSOC., INC
CONFLICT OF INTEREST INFORMATION FORM
County/Region: (List your county if you are a staff person or list your region if you are a Board Member)
Affiliation to the Agency:
Please describe below any relationships, positions or circumstances in which you are involved that you believe could contribute to a Conflict of Interest, as defined by the North Central WV Community Action Assoc., Inc. Procedure on Conflicts of Interest.
I hereby certify that the information set forth above is true and complete to the best of my knowledge. I have read, understand and agree to abide by the North Central WV Community Action Assoc., Inc. Conflict of Interest Procedure. I further agree to report any possible conflicts as they might arise apart from this annual report.
Leave this empty:
Your legal name
Your email address
If you have questions about the contents of this document, you can email the document owner.
Document Name: conflict of Interest form 3 sign
Agree & Sign