Mohawk ID:
Name:
Person, group or organization providing the gift, hospitality or entertainment:
Describe gift, meal, hospitality or entertainment (including date, circumstances, type of transportation (if provided):
Description of purpose of gift, meal, hospitality or entertainment:
Entertaining company’s representative:
Other Mohawk College employees attending event or receiving gift and their relationship with provider:
Manager’s remarks whether appropriate to accept gifts, hospitality or entertainment and why:
Gifts, Meals, Hospitality, Entertainment Disclosure Form
This form is to be used by an employee to disclose and obtain approval before accepting gifts, hospitality or entertainment
outside of the limits set forth in the Conflict of Interest Policy. The employee’s manager is responsible for evaluating the
circumstances surrounding the gift, meal, hospitality or entertainment for potential conflicts of interest and/or appearance
of impropriety in accordance with the policy.
Employee Information
Manager’s Information
Disclosure Details
Estimated cost/value of each significant item provided:
TO BE COMPLETED BY MANAGER:
SUBMITTED BY: APPROVED BY:
Received by Conflict of Interest Committee: