Fillable 2015 16 Edcc Foundation Relationship Disclosure Form (Edmonds Community College)

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2015 16 Edcc Foundation Relationship Disclosure Form (Edmonds Community College)

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BOARD/STAFF*RELATIONSHIP*DISCLOSURE*
SCHOLARSHIP*RECIPIENTS*
!
The!Edmonds!Community!College!Foundation,!in!its!annual!IRS!Form!990,!is! required!to!disclose!
whether!individuals!receiving!scholarships!are!related!to!any!member!of!the!staff!or!Board!of!
Directors!of!the!Foundation.!
!
Attached! for! your! review! is! the! current! staff! and! Board! of! Directors! roster! for! the! Edmonds!
Community!College!Foundation.!Please!identify,!in!the!space!provided!below,!the!names!of!any!
individuals!to!whom!you!are!related!either!by!blood,!marriage,!immediate!or!extended!family.!
!
Disclosure!of! relationships!is!for! information!purposes! only,!and! will! in! no! way!disqualify! you!
from!receiving!the!scholarship!awarded!for!the!current!academic!year,!nor!will!it!eliminate!you!
from!consideration!of!scholarships!in!subsequent!years.!!However,!submission!of!the!disclosure!
is!required!and!failure!to!complete!and!sign!the!form!will!result!in!an!incomplete!packet,!which!
will!disqualify!you!from!receiving!your!scholarship.!
!
As!a!recipient!of!a!schol arship !from!Edmonds!Community!College!Fou ndati on ,!I!have!reviewed!
the!list!provided!to!me!of!staff!and!Board!of!Directors!and:!
!
!! I!am!not!related!to!any!persons!currently!a!member!of!the!staff!or!Board!of!Directors!of!
Edmonds!Community!College!Foundation.!
!
OR!
!
! I!have!a!family!relationship!with!the!following!person(s)!
!
! Name:!_______________________________Relationship:_______________________!
!
Name:!_______________________________Relationship:_______________________!
!
! Name:!_______________________________Relationship:_______________________!
!
!
!
____________________________________!
Signature!
!
____________________________________!
Date!
*
BOARD/STAFF*RELATIONSHIP*DISCLOSURE*
For*the*fiscal*year*ended*June*30,*2015*
*
BOARD*AND*STAFF*ROSTERS*
*
Current Board Members
Joe Andre
Mark Bailey
Nils Bajczuk
Ken Chandler
Diana Clay
Adam Cornell
Nick Echelbarger
Nicki Elsberry
Doug Fair
Libby Lewis
Dean Nichols
Steve Pennington
Wendy Popke
Meg Rankin
Ken Reid
Dimitra Scott
Jean Sittauer
Janette Turner
Past Board Members
5 years (since June 2010):
Ruth Arista
Ken Batali
Brian Ferrill
Kevin Hanchett
Logan Harris
Kim Karrick
Mike Meiers
Karen Miller
MaryAnn Sailors
Vaughn Sherman
Current Staff Members
Marcia Bennison
Julie Colgan
Jason Hamman
Brad Thomas
Past Staff Members
5 years (since June 2010)
Susie Beresford
Kathy Coffey
Celeste Douville
Tonya Drake
Kristyl Drew
Lorrie Gomes
Linda Krouse
Chris Marx
John Michaelson
Carol Summers
Pamela Wanser
Jennifer Williams
*
*
!
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2015 16 Edcc Foundation Relationship Disclosure Form (Edmonds Community College)

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Completed 26 July 2020

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