1THE KU ALUMNI ASSOCIATION

BOARD OF DIRECTORS CONFIDENTIALITY AND CONFLICT OF INTEREST DISCLOSURE STATEMENT

1. Confidentiality

As a member of the Association’s Board of Directors, you have access to information that is either confidential by law or by Association policy. You occupy a unique position of trust. Protecting information and avoiding conflicts of interest are central to maintaining that trust. Generally, all information concerning Association business relationships is confidential and must not be discussed with or released to other parties outside the Association. There are specific policies to guide those individuals who are authorized to release such information, and all inquiries should be referred to appropriate departments. The Communications Department can help you find the right people to respond when you receive such requests for information. Confidential information includes, but is not limited to, alumni records data and Association business relationships. 2. Conflict of Interest

Proper governance of a charitable organization greatly depends upon a governing board (“Board”) whose members give their time for the benefit of the organization. In rendering this service, and because of the varied interests and backgrounds of Board members, it is conceivable that situations involving a dual interest may occur. Some of these might be interpreted as a conflict. Similar situations could arise among the officers and key employees responsible for administering the decisions of the Board.

Should such a conflict of interest occur, the affected person must inform members of the Board in order to resolve the situation. It is the duty of each Board member and officer of the KU Alumni Association (Association) to disclose any of the following with respect to himself/herself or any family member. The remainder of this form is used to provide this information.

Time Period: July 1, 2015 through the date signed ______

Please consider the following issues when considering your potential conflict of interest situations and provide details for all questions to which you respond “Yes” in the space below. For the purposes of completing this form, “Family Member” includes your spouse, ancestors, children, grandchildren, great-grandchildren, siblings, and the spouses of: children, grandchildren, great-grandchildren, and siblings. Also, “business relationship” does not include a relationship between an attorney and client, a medical professional (including psychologist) and patient, or a priest/clergy and penitent/communicant. Thank you. 0316 1) Did you or a Family Member receive payment from the □ No □ Yes Association for any business transaction, either directly or indirectly (please provide detail through a business entity? below) 2) Other than as a full-time employee of the Association, did you □ No □ Yes or a Family Member receive compensation from the Association (please provide detail that is reportable on Internal Revenue Service Forms W-2 or below) 1099? 3) Do you or a Family Member have employment or a business □ No □ Yes relationship with any other Association employee or Board (please provide detail member? below) 4) Do you or a Family Member have employment or a business □ No □ Yes relationship with any entity that is in competition with the (please provide detail Association? below) 5) Do you or a Family Member have employment or a business □ No □ Yes relationship with any entity that is in competition with the Association for (please provide detail the purchase or sale of property or services? below) 6) Do you or a Family Member hold any position in a public office, □ No □ Yes whether elected or employed, which will require participation in (please provide detail matters relating to the Association? below) 7) Do you or a Family Member have any employment or volunteer □ No □ Yes relationship with the University of Kansas or any University of (please provide detail Kansas affiliated entity (other than the Alumni Association)? below) 8) Is there any other matter as to which your duty to the □ No □ Yes Association could be compromised by a competing interest? (please provide detail below)

Discuss details below (please reference the applicable question number)

I have read and agree to comply with all aspects of confidentiality and conflict of interest in this agreement or otherwise required by the KU Alumni Association. I further agree not to disclose confidential information to anyone outside of the Association at any time, either during or after my Board tenure, without the prior written consent of the Association.

______Date Board Member Signature

______Board Member Printed Name

0316