Conflict of interest questionnaire – Burlington County Footlighters

Name *

First

Last

Email *

What position(s) do you hold? *

I have received a copy of the BCF Conflict of Interest Policy *

The full policy can be found at https://bcfootlighters.com/code-of-conduct/

I have read and understand the policy *

I agree to comply with the policy *

I understand that BCF is charitable organization and in order to maintain its federal tax exemption it must engage primarily in activities which accomplish one or more tax-exempt purposes *

Are you an officer or service in another capacity? *

Officer
Committee Chair or Staff
Other

Independent Director

An independent director as defined by the IRS is generally someone who, in the last three years, was not an employee of BCF or has a "significant" business relationship with BCF (payment over $10,000, not including regular reimbursements) and was party to a reportable transaction. We are not aware of anyone in any of these situations at BCF who is not an independent director, but we have to ask the question regardless.

Are you an "independent" director? *

Financial Interests

Do you have any financial interests in decisions made by your position(s) at Footlighters. These may include vendor selection, selecting of staff/contractors or other purchases.

Do you have a financial interest (current or potential), including a compensation arrangement, as defined in the Conflict of Interest policy with BCF? *

Organizational Interests

Are you an officer or staff member of any arts appreciation, arts education or other performing arts organization and/or group? *

Please list the organizations you are a member of your relationship(s) with them.