I do hereby attest and affirm that I have received, read, and understand the Lane Workforce Partnership (LWP) Conflict of Interest Policy and agree to be bound by it. I will promptly inform the LWP Board Chair of any material change that develops in the information contained herein.

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* 1. I am a (select all that apply):

  • I represent a private sector employer that has current business/contractual dealings with LWP or one or more of the WIOA or federally funded service providers.
  • I have a family member who is employed by a current or potential WIOA or federally funded service provided or by another organization that provides services direction to LWP.
  • I represent a WIOA-funded service provider/contractor.
  • I represent a One-Stop Operator.
  • I represent a One-Stop Partner.
I promise and attest that I will hereby declare before a vote or discussion on the matter, the nature and extent of a conflict on interest. I will hereby voluntarily withhold from participating in any discussion pertaining to this matter and abstain from voting on the subject. I further understand that this shall not prohibit me from responding to any direct questions on the matter from other LWP Board Members.

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* 2. Name

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* 3. Organization and Title

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* 4. Date

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