Board Member, Officer, and Executive Staff Annual Update

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Contact Information

If provided, please review and update your contact information as needed. If no information is provided, please provide this information.

First Name(Required)

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Conflict of Interest Questionnaire

The following questionnaire must be completed annually by all officers, board members, and staff of Affirmation: LGBTQ Mormons, Families & Friends (“Affirmation”). Answers to this questionnaire should include relationships or situations for the year preceding the date signed or any known potential relationships or situations in the future.

Question 1: Relationships(Required)

1. Are you related by blood, marriage, or adoption to any other officer, director, or employee of Affirmation; or any owner, investor, officer, agent, or employee of any fundraising professional firm or a vendor under contract with or providing goods and services to Affirmation?

Yes

Question 2: Gifts, Compensation, Benefit(Required)

2. Are you an owner, investor, officer, agent, or employee of any fundraising professional firm or a vendor under contract with or providing goods and services to Affirmation; or have you received any gifts, loans, payments, discounts, promises of any compensation or benefit or could you potentially benefit in any way from any third-party providing goods or services to Affirmation?

Yes

Question 3: Prohibitions to Solicitation(Required)

3. Have you been prohibited by a court or other legal authority from soliciting contributions or been found to have engaged in unlawful practices in the solicitation of contributions or the administration of charitable assets in any jurisdiction?

Yes

Question 4: Convictions(Required)

4. Have you ever been convicted of a misdemeanor or a felony?

Yes

Explanation(Required)

If you answered yes to any of the above questions, please use the space below to provide an explanation of your relationship or situation.

Signature

Give or Get Pledge

As a board member of Affirmation, you have a responsibility to ensure the financial health of the organization. This includes directly contributing financially to Affirmation and actively fundraising on behalf of Affirmation to provide the opportunity for others to contribute financially toward the fulfillment of Affirmation's mission.

You are invited at this time to complete this pledge, listing the amount, method, and types of support for Affirmation's work in the coming year that you will give directly, or get from others.

We invite you to take an inventory of the ways you can support Affirmation and to pledge a financial contribution that is personally significant. We ask that donations to Affirmation be one of your top three contributions of the year and hope to have 100% participation in our fundraising efforts by the board.

What is your preferred schedule for giving?

Annually

Monthly

Personal Annual Contribution

Excluding event or conference tickets.

Would you like to make this contribution now? If so, please use this link to open a donation page in a new tab or window.