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Board Member Agreement

Please complete the form below. Required fields marked with an asterisk *

Board Member Agreement 

Note: The purpose of this document is to provide disclosure. The AXIS International Academy “the School” Board operates according to its own Bylaws and applicable law in regard to conflicts of interest. This form is a public document and will be available at the School for inspection by other board members, the staff, or the community.

Background

2. I affirm that I am at least 21 years of age by the date of appointment to the AXIS International Academy Board.*
Answer Required
3. Indicate whether you have ever been convicted or pled “no contest” of one or more of the following:*
Answer Required
Yes
No
a. a misdemeanor related to honesty or trustworthiness,
b. a felony, or
c. any criminal offense involving children.
4. Indicate if you have ever entered into a settlement agreement, consent decree, adjournment in contemplation of dismissal, assurance of discontinuance or other, similar agreement with the Securities Exchange Commission, Internal Revenue Service, the U.S. attorney general or the attorney general of any state, a U.S. or district attorney or any other law enforcement or regulatory body concerning the discharge of your duties as a board member of a for-profit or non-for profit entity or as an executive of such entity. *
Answer Required