Sample Agreement To Resolve A Conflict Of Interest Template Page 2

____ Check here if the head of the academic unit and the academic administrator

have determined it is not possible to agree on a plan to resolve the conflict of

interest. Therefore, the faculty member has agreed to discontinue the romantic

and/or sexual relationship until the faculty member no longer has supervisory

responsibility for the student.

The signatures below confirm approval of this agreement to resolve the conflict

of interest.

_________________________________

Name of head of unit (e.g., dean or director)

Title

Note: With the above signature, the head of the unit also confirms that [Student] agrees

with the terms of this conflict resolution plan.

_________________________________

Name of academic administrator (e.g., department chair or academic program

director)

Title

_________________________________

Name of faculty member

Title(s)

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Parent category: Business