Conflict of Interest Disclosure Conflict of Interest Survey It is the policy of Nonprofit Innovations, Inc. (“NII”) to prevent an officer, director, employee or appointee from engaging in conduct in which he or she has a conflict of interest or the appearance of conflict of interest arising out of his or her relationship with NII. To implement the policy, NII requires that all officers, directors, or employees of NII to complete a conflict of interest survey annually. A conflict of interest is any situation in which a person has competing motivations or responsibilities, real or perceived, the resolution of which could be to the detriment of NII or could result in gain or the appearance of gain to him or her. Conflicts of interests would include, for example, any direct or indirect competition, negotiation or business dealings with NII; any direct or indirect position or financial interest held in an outside concern that competes, negotiates or does business with NII; any gifts, monetary awards, payments, services or special privileges that are dispensed to or are received or solicited from any outside concern that competes, negotiates or does business with NII; and any disclosure or use of information relating to NII for the benefit, advantage or profit of either the individual or an outside concern. Please list in the space below all actual and potential conflicts of interest arising out of your relationship with NII. If you receive payments in connection with any actual or potential conflict of interest, please indicate this as well and specify whether the payments are based on fair market value or other terms. If you are unaware of any conflicts, write “None.” By completing this form, you also certify that you have received a copy of NII’s conflict of interest policy, have read and understand said policy, agree to comply with the policy, and understand that NII is a charitable organization and in order to maintain its federal tax exemption it must engage primarily in activities that accomplish one or more of its tax-exempt purposes. Conflicts * If none, please enter "None." First Name * Last Name * Email * Date Signature * signature keyboard Clear Submit If you are human, leave this field blank.