DISCLOSURE BY A PUBLIC EMPLOYEE OF A GIFT, BENEFIT OR ITEM OF SUBSTANTIAL VALUE AS REQUIRED BY G.L. c. 268A, § 23(b)(3) and 930 C.M.R. § 5.04(3)
Any employee who has received gift given as a result of their position with the Hopkinton Public Schools and with a fair market value of between $10 and $49 must complete this form and submit to his/her supervisor.
This is a computer-fillable form. The text box area will expand as you type. When complete, print it out, sign and date it, and provide to your supervisor.
Name |
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Title or Position |
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School or Department |
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What is/are the gift(s)? Describe each briefly. |
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What is the actual or estimated fair market value of the gift? |
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Who is/are the donor(s)? (Provide full name(s).) |
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Why was the gift given? (Example: Holiday, End of School Year) |
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What is the donor’s interest in your performance of official duties? (Example: parent of child I teach) |
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Signature |
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Date |
Policy Name Revised 5.29.2019
School Committee Policies
- A - Foundations and Basic Commitments
- B - School Board Governance and Operations
- C - General School Administration
- D - Fiscal Management
- E - Support Services
- F - Facilities Development
- G - Personnel
- H - Negotiations
- I - Instructional Program
- J - Students
- K - School-Community Relations
- L - Education Agency Relations