Chair of the Executive Committee
Ithaca College Board of Trustees
316 Job Hall
953 Danby Road

Ithaca, NY 14850

I have reviewed and read the College's "Conflict of Interest Policy" approved by
the Board on May 20, 1995. I am in compliance with the policy except as
specifically stated below.

 

Sincerely,

   
   
   

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(Date)

 

(Name)

Exceptions (Note: If there are none, please write "NONE"):