Statement Concerning Potential Conflict of Interest Board of Directors are asked to please disclose their possible conflicts of interest as it pertains to the Carlisle Area Chamber of Commerce Name and address of employer and position: Business and/or professional affiliations: Name(s) of persons closely related to you who and organizations with which you are affiliated which are presently transacting business with the Chamber or might reasonably be expected to do so in the next twelve months: Please list the Name and Your Affiliation Date * Format: M/d/yyyy Electronic Signature The undersigned hereby affirms the foregoing information is true and correct to the best of the undersigned's knowledge, information and belief; this information is provided in accordance with the Chamber's Policy on Conflict of Interest. First Name * Last Name *
