AAENP Nomination Conflict of Interest Statement and Confidentiality Agreement

At this time, I am a board member, committee member, employee or other leader of the following organizations:

Certification Statement #1

Now this is to certify that I, except as described below, am not now nor at any time during the past year have been: 1) A participant, directly or indirectly, in any arrangement, agreement, investment, or other activity with any vendor, supplier, or other party doing business with AAENP which has resulted or could result in personal benefit to me.

Certification Statement #2

Now this is to certify that I, except as described below, am not now nor at any time during the past year have been:


2) A recipient, directly or indirectly, of any salary payments or loans or gifts of any kind or any free service or discounts or other fees from or on behalf of any person or organization engaged in any transaction with AAENP.

Any exceptions to 1 or 2 above are stated below with a full description of the transactions and of the interest, whether direct or indirect, which I have (or have had during the past year) in the persons or organizations having transactions with AAENP.

Confidentiality Agreement

Respecting the privacy of our stakeholders, donors, members, staff, volunteers of AAENP and of AAENP itself is a basic value of AAENP. Personal and financial information is confidential and should not be disclosed or discussed with anyone without permission or authorization from the President or Chair. Care shall also be taken to ensure that unauthorized individuals do not overhear any discussion of confidential information and that documents containing confidential information are not left in the open or inadvertently shared.


Staff, volunteers, regional directors, and board members of AAENP may be exposed to information that is confidential and/or privileged and proprietary in nature. It is the policy of AAENP that such information must be kept confidential both during and after employment or volunteer service. This includes and is not limited to membership database information. Membership database information may only be used for official AAENP business and may not be used for any other organization or purpose without the consent of the AAENP Board of Directors.


Unauthorized disclosure of confidential or privileged information is a serious violation of this policy and will subject the person(s) who made the unauthorized disclosure to appropriate discipline, including removal/dismissal.

I hereby certify that I have read, understand and agree to the AAENP confidentiality policy. I also agree to abide by the adopted bylaws and policies of AAENP.