Form Center

4. ALL TOWN STAFF AND BOARD AND COMMITTEE MEMBERS ARE REQUIRED TO ACKNOWLEDGE RECEIPT OF THE CONFLICT OF INTEREST LAW AND SUBMIT A COPY OF PROOF OF COMPLETION OF THE ONLINE ETHICS COMMISSION TRAINING MODULE.
8. YOUR INFORMATION
12. First Name:
13. Last Name:
14. Position/Title/Role:
16. Email Address:
17. Primary Phone Number:
19. Department/Board/Committee Name:
25. ACKNOWLEDGEMENT OF RECEIPT OF CONFLICT OF INTEREST LAW
29. Enter Your Full Name:
    By Typing Your Full Name Above You Are Acknowledging That You Have Received and Read the Massachusetts Conflict of Interest Law Found At www.amherstma.gov/conflict
30. Date of Receipt:
    Date of Receipt:
37. UPLOAD AND SUBMIT PROOF OF COMPLETION OF ONLINE ETHICS MODULE
41. Instructions
    There are three ways to save/upload the receipt from the Online Ethics Commission module completion. 1.) Print the receipt and take a picture of it with your phone, then upload the photo below. 2.) Save the receipt as a PDF and upload the PDF. 3.) Take a screen shot or save the receipt as an image and upload the image below.
43. Upload Your Receipt Proof Of Online Eithics Module Completion
49. SUBMIT YOUR ACKNOWLEDGMENT AND RECEIPT
53. Leave the box below checked and enter your desired email address to recieve a copy of your form submission:
Leave This Blank:


55. 1. Receive an email copy of this form.
56. Email address

    This field is not part of the form submission.

57. Submit

* indicates a required field