Skip to main content

Board Forms

Potential Conflict Disclosure Form

The Connecticut Bar Foundation Conflict of Interest Policy requires board members to immediately disclose a potential conflict of interest in writing to the board president. Complete this form to make any such disclosure.  

Potential Conflicts Arising with Prospective Grantees:

Please list any organizations that might reasonably be expected to seek funding from the Connecticut Bar Foundation on which you:

  • currently serve as a member of the board;
  • have served on the board within the past two years;
  • have a current business relationship with; or
  • are otherwise substantially involved.

An organization is eligible to seek funding from the Foundation if it is a nonprofit corporation whose principal purpose is providing legal services to the poor in Connecticut.

Potential Conflicts
First Name
Last Name
Today's Date