Conflict of Interest Form — California Council for Wildlife Rehabilitators

Conflict of Interest Form

Name

First Name

Last Name

CCWR Position (check all that apply)

Board of Directors

Committee Member

Committee Chair

Committee Co-Chair

Conflict of Interest is described as any relationships, transactions, positions you hold (volunteer or otherwise), or circumstances that you believe could contribute to a conflict of interest between CCWR and your personal interests, financial or otherwise.

Conflict of Interest Statement:

If you have a conflict of interest, please explain.