CIRCLE OF FRIENDS IMPACT SCHOLARSHIP
SELECTION COMMITEE
ACKNOWLEDGEMENT FORM

 

 
Selection Committee ACKNOWLEDGMENT FORM
By filling out the information and checking the box below, I agree to become a member of the Circle of Friends Impact Scholarship Selection Committee (“Selection Committee”). I have received, read and agree to abide by all of the rules, regulations and obligations of the Committee as described in the Circle of Friends Impact Scholarship Selection Committee Charter (the “Charter”), attached hereto as Exhibit A, including, but not limited to, the Confidentiality and Conflict of Interest provisions therein.
Date *
Date
Name *
Name
Address *
Address
Phone *
Phone
Conflicts of Interest
All members of the Selection Committee must evaluate the eligibility of all applicants without bias and make selection recommendations based on the established objective criteria for the scholarship. Selection Committee members should avoid any situation where personal and business relationships could have or give the appearance of having, undue influence on the Selection Committee member’s judgment in matters under consideration. A Selection Committee member has a conflict of interest if: a) The member is related by blood, marriage or adoption to a scholarship applicant; b) The member will receive a direct or indirect financial benefit from recommending a scholarship to a particular applicant; or c) Due to personal or business relationships, or any other reason, the member exerts influence to recommend a recipient without regard to the scholarship criteria. If a member has an actual or potential conflict of interest concerning an applicant, the member will disclose the conflict to the rest of the Selection Committee. The member shall not discuss the scholarship applicant with anyone on the Selection Committee and will not participate in, or be present during, any Selection Committee deliberations or vote concerning that applicant.