Conflict of Interest Form - Ice Hockey

Indicates required field

Do NOT fill out this form if you do not have a conflict of interest to report.

School

Team Gender

Boys

Girls

Both

Name of Person Completing This Form:

Title of Person Completing this Form

Email for confirmation of submission

I certify that I am authorized to complete this form on behalf of the school district.

Official's Name (If more than one, please complete a separate form for each official.)

Conflict of Interest (select all that apply)

Currently employed in the district.

Previous employment in the district within the past 10 years.

A close relative employed in the district.

A child attending any school in the district.

A graduate of the school within the past ten years.