TPC Conflicts of Interest Form

Read our Conflicts of Interest Policy.

Conflicts of Interest Form

  • Please disclose the following information, for you and your Family Members (which includes spouse, siblings, children, grandchildren among others, please see policy for full list), with respect to each non-profit organization in Massachusetts with which you or your Family Members, to your knowledge, are involved.
  • • Member of governing board, advisory board, or policy making committee, currently or within the last 3 years • Significant personal relationship (donation of $5,000 or more or volunteers more than 100 hours a year) • Involved with the annual independent audit • Employee, vendor or paid consultant • Other relationships (including, but not limited to actual or potential ownership/investment interest or compensation arrangement)
  • In addition, I have read The Philanthropy Connection Conflict of Interest Policy and have disclosed below any additional conflicts referenced under Part II of the policy. This disclosure statement shall be kept on file with the Clerk of TPC. If you have nothing to disclose, please write “none.”


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