Associations with Cultural Organizations

Conflict of Interest Policy

The Wisconsin Arts Board requires all applicant review panelists to comply with the following Wisconsin Arts Board conflict of interest policy.

Wisconsin Arts Board members, staff or panelists are required to withdraw from all consideration of a proposal affecting an organization where a conflict of interest has been indicated.

The following conflict of interest policy is included in the Wisconsin Arts Board's Administrative Rules:

CONFLICT OF INTEREST:

Any member of the Board, peer review panels, advisory committees, and staff with a direct financial or employment interest relating to any grant application before peer review panels or advisory committees, will inform the Board of such an affiliation prior to the review of grant applications.
Affiliation, defined. Affiliation with an applicant includes:
1. receipt of direct financial benefit from the applicant organization or project being reviewed;
2. serving as an employee or governing board member of an applicant organization being reviewed;
3. serving with or without payment as a consultant to an applicant on the applications being reviewed;
4. familial relationship with an applicant or staff or board member of an applicant organization;
5. recent receipt of free tickets or other benefits from an applicant being reviewed.
An "associations with cultural organizations" form is retained on file and reviewed annually for each board member, citizens who serve on peer review panels and advisory committees, and staff.

Questions? Contact Vivienne Timchenko at Vivienne.Timchenko@wisconsin.gov or +1 608-266-8045.

You will recieve a copy of this form upon signing (sent to the email recorded within this form). While this form will be archived appropriately by the Wisconsin Arts Board, please feel welcome to retain this documentation for your records.

Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Email*

example@example.com

Creation and Presentation Grant Program - Full YearCreation and Presentation Grant Program - New ApplicationsCreative Communities Grant Program - Local ArtsCreative Communities Grant Program - Folk Arts & Folk Arts Apprenticeship ProgramCreative Communities Grant Program - Arts EducationWoodland Indian Arts ProgramOther

Original disclosureAmended disclosure

List all cultural organizations that presently employ you, or on whose Board of Directors you currently serve:

List all cultural organizations that presently employ, or on whose Board of Directors serves, a person with whom you have a familial relationship:

List other cultural organizations with which you, or a person with whom you have a familial relationship, may have an affiliation that you would like to make known:

Please confirm, by signing below, that all requested information has been remitted to the full strength of your knowledge at the time of submission:*