I declare that I hold the following personal and/or pecuniary interest(s):

Pecuniary interests are business interests (eg employment) and wider financial interests (eg investments, assets).

Please state below any personal conflicts of interest

State their name, their relationship to you, the organisation, and the nature of the interest
Please state the name of the organisation, the position held, the date you were appointed/elected to the post, and if appropriate the date of termination of the post
To the best of my knowledge the information supplied above is correct and complete. I understand that it is my responsibility to declare any conflict of interest/loyalty, business or personal that relates directly or indirectly, to myself or any relation in any contract, proposed contract or other matter when present at a meeting at the charity where such contract or matter comes under consideration. I understand that I must withdraw from any meeting during the discussion of such contract or matter and must not vote in respect of it. I agree to review and update this declaration annually and give consent for the information provided to be used in accordance with the charity’s conflicts of interest policy.