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PALM BEACH COUNTY ;t'tWT��4 BEACH
• A..,� CODE OF ETHICS
CLERK
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Legal Name: � ''
(Please print clearly)
Employee Identification Number: N/A
Agency/Municipalfty: Boynton Beach 4Igoard: } rr}
4- VIS6IT
By signing this acknowledgement, 1 am attesting that I have done the following:
[ ] Read the Palm Reach County Code of Ethics Ordinance&td±Cllck to follow link)
AND
Have completed additional training by viewing one of the following:
[q-fhe Code of Ethics Training Program on the IntranetJinWrnet.(Cft1+C11ck to follow unk)
[ ] The Code of Ethics Training Program on YouT,�. (Ctrl+Click to fotow llnk)
j ] The Code of Ethics Training Program on DVD.
[ ] A live presentation given on .20L__.
1 understand that I am responsible far understanding and abiding by the Palm Beach
County Code of Ethics as I conduct my assigned duties during my term of employment
1 also understand that the infbnnation in this policy is subject to change. Policy changes
will be communicated to me by my supervisor or through official notices. !
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(Legal Slpnaim)
Adtrlsay Board Membrars: r6 srg»ed f+arrrts to Ap prfate Adv�aary Re tah*
PLEASE SUBMIT THIS FORM TO APROPRIATE PARTY AS HIGHLIGHTED ABOVE
PLEASE DO NOT SUBMIT THIS FORM TO THE COMMISSION ON ETHICS
300 North Dixie Highway,Suite 450,West Palm Beach,FL 33401
PHONE: 561.355-1915 FAX: 561.355-1904
Hotline: 877.766.5920 E-mall: ethics@paImlbeacheountyethics egm
Website: za5=almbeachce1W1vethlcscoM
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