Conflict of Interest Disclosure Contact information Date First name * Last name * Position * Board officer Board member Committee member volunteer Supporter Unsure Section Please describe below any relationships, transactions, positions you hold (volunteer or otherwise), or circumstances that you believe could contribute to a perceived conflict of interest between The Arc of DFW Area and your personal interests, financial or otherwise: Please specify other non-profit and for-profit boards you (and your spouse) sit on, any for-profit businesses for which you or an immediate family member are an officer or director, or a majority shareholder, and the name of your employer and any businesses you or a family member own: Conflicts to report * I have no potential conflict of interest to report I have the following potential conflicts of interest to report: I have the following potential conflicts of interest to report (#1) I have the following potential conflicts of interest to report (#2) I have the following potential conflicts of interest to report (#3) I have the following potential conflicts of interest to report (#4) I have the following potential conflicts of interest to report (#5) Confirmation * I hereby certify that the information set forth above is true and complete to the best of my knowledge. I have reviewed, and agree to abide by, the Conflict of Interest Policy of The Arc of DFW Area. Submit
