Scholarship Board Conflict / Recusal Report

Complete this form only when an actual or potential conflict of interest arises involving a scholarship applicant.

I am disclosing a relationship or circumstance that may affect, or reasonably appear to affect, my impartial participation in the review or selection of a scholarship applicant.

I am disclosing a relationship or circumstance that may affect, or reasonably appear to affect, my impartial participation in the review or selection of the scholarship applicant.