After reviewing the above documents, please copy and paste the green text into an email to Kenny, along with a description of any activity. 

kweiss@houstonhillel.org

Each director, principal, officer, and member of a committee with board delegated powers shall annually sign a statement which affirms that such person:

1. Has received a copy of the Board of Directors Responsibilities, Conflict of Interest Policy, as well as the Houston Hillel Whistle Blower Policy;
2. Has read and understands the policies;
3. Has agreed to comply with the policies; and
4. Understands that Houston Hillel is a charitable organization and that in order to maintain its federal tax exemption it must engage primarily in activities which accomplish one or more of its tax-exempt purposes.
 
Each member of Houston Hillel Board of Directors shall also annually affirm their agreement with the Board of Directors Responsibilities.

By  entering my name below I acknowledge that I have read the following board documents: Board of Directors Responsibilities, Conflict of Interest Policy, and Whistleblower Policy. I understand that Houston Hillel is a charitable organization and that in order to maintain its federal tax exemption it must engage primarily in activities that accomplish one or more of its tax-exempt purposes. 

Neither I nor any member of my family has in the past, is presently, or plans to engage in any activity that contravenes the Conflict of Interest Policy, except as specifically noted below.

(In the space below please fully describe any activity that contravenes the Conflict of Interest Policy. If none, please state “No contravening activity.” Please also fully describe any activity that you wish reviewed in order to determine whether or not it contravenes the Conflict of Interest Policy. If none, please state “No activity to review.”)

Description of activity (or statement of no activity, or activity to review):

Name:

Date: