Conflict of Interest Disclosure Form | United Way of Lincoln and Lancaster County

Please list any relationships you or your family members may have with partner agencies or other funded programs supported by United Way of Lincoln and Lancaster County (UWLLC) that could engender a concern over one or more conflicts of interest. In addition please list business relationships you or your family members may have with UWLLC or its funded partners which may be a potential conflict of interest. Please click here and review the policy then complete the information below and hit the submit button.

I am currently involved with the following local organizations:

Please list the organizations you are personally involved with and and the nature of your involvement.

Organization	Nature of Relationship

My family member is currently involved with the following local organizations:
Please list any local organizations in which you have family members involved with.
Organization Nature of Relationship
I have read and understand the definition of conflict of interest as it pertains to my relationship with United Way of Lincoln and Lancaster County. I have fully disclosed any known or potential conflicts of interests and agree to comply with the UWLLC conflict of interest policy. I understand the organization is charitable and must engage primarily in activities which accomplish one or more of its tax-exempt purposes.
Agreement
- By selecting this box, you are indicating that you have disclosed any known or potential conflicts of interest as stated above.
Full Name
Please enter your first and last name.
Email