Voce, Cory CI Y ll e,urf J
��,�5�oau o����, ` I " C'r E{'i�'�C OFFICE'
H
y PALM BEACH CONY
r p
fl 1
• lc- I • CODE OF ETHICS
94;;',f , TRAINING ACKNOWLEDGEMENT
t41
IkACH G43J
Honesty-Integrity-Character
Legal Name: IV
Quu\ '�C1 ci \load (Please print clearly)
�'
Employee Identsifiica i�Number:
Agency/Municipality: Q 6)-1,ALV\ 1A kith Dept/Board: FLdth('(lOA t 100-\ kIVI(S0I'
By signing this acknowledgement, 1 am attesting that I have done the following:
[ Read the Palm Beach County Code of Ethics Ordinance (Ctrl+Click to follow link)
AND
Have comple d additional training by viewing one of the following:
[she Code of Ethics Training Program on the Intranet/Internet. (Ctrl+Click to follow link)
[ ] The Code of Ethics Training Program on YouTube. (Ctrl+Click to follow link)
[ ] The Code of Ethics Training Program on DVD.
[ ] A live presentation given on , 20_
i understand-that-I-am-responsible-for understanding atfd abidmg by-the Patir-Beach —
County Code of Ethics as I conduct my assigned duties during my term of employment.
I also understand that the information in this policy is subject to change. Policy changes
will be communicated to me by my supervisor or through official notices.
01111
(Legal Signature) (Date)
Advisory Board Members: Submit signed forms to Appropriate Advisory Board Representative
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-mail: ethics@palmbeachcountyethics.com
Website: www.palmbeachcountyethics.com
Rev.01/2017