Conflict of Interest (COI) Acknowledgment & Disclosure

Name *

First Name

Last Name

COI Acknowledgement *

As a member of the board of directors of the Wedgwood PTA, I confirm as follows: - I have received a copy of the conflict of interest policy. (Above) - I have read and understand the policy. - I agree to comply with the policy. I understand that Wedgwood PTA is a tax-exempt association and, in order to maintain its federal tax exemptions, it must engage primarily in activities which accomplish one or more of its tax-exempt purposes.

I agree.

COI Disclosure *

Do you have a conflict of interest or potential conflict of interest? NOTE: Seattle Public Schools employees should answer this question "Yes".

No

Yes

Unsure