Conflict of Interest Disclosure

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This acknowledgement form complies with the CareerSource Florida, Inc. (CSF) Conflict of Interest Disclosure policy, which promotes ethics in operations and transparency among CSF board members. Members of the CSF Board of Directors are expected to safeguard their ability to make objective, fair and impartial decisions.

Board members are required to read and confirm this acknowledgement upon appointment to the CSF Board of Directors. Board members are also required to disclose potential, real, or perceived conflicts of interest in writing to the CSF professional team and its general counsel prior to any board meeting in which business involving these interests will be discussed.

Full disclosure does not remove a conflict of interest. If the board member is not certain he or she is in a conflict of interest position, they may consult CSF general counsel, who serves as the ethics and public records officer for the Board of Directors.
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Name* This field is required.
First Name
Last Name
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Email* This field is required.
example@example.com
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CAREERSOURCE FLORIDA BOARD OF DIRECTORS CONFLICT OF INTEREST DISCLOSURE STATEMENT: To the best of my knowledge, I am unaware of any real, potential or perceived conflicts of interest involving me or a relative* that may limit my ability to perform my duties as a member of the CareerSource Florida Board of Directors.* This field is required.* Includes parents, step-parents, spouses or domestic partners, children, step-children, full or half siblings, in-laws, sibling in-laws, grandparents, great-grandparents, step-great-grandparents, aunts, uncles, nieces, nephews and grandchildren.
YESNO
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I hereby disclose my interests and relationships that could give rise to a conflict of interest:* This field is required.
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Ok
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I have reviewed the conflict of interest disclosure policy for the CSF Board of Directors and agree to comply with the terms of the policy. I will promptly report any such conflict of interest that may arise during the term of my tenure as a board member while conducting CSF business.* This field is required.
ConfirmDeny
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Signature
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