Professional Conduct Disclosure Form for Elected Positions

Starting in 2019, the below documentation is required in order to be placed on the ballot for an elected position within the Entomological Society of America (ESA). 

Please complete this form no later than June 2, 2021.

If you have questions regarding the Professional Conduct Disclosure, you may contact ESA's Executive Director, Chris Stelzig.


CERTIFICATION 

The undersigned hereby affirms that he/she has read, understands, and agrees to comply with the ESA Code of Conduct and Ethics Statement, and other policies and procedures established by ESA, as amended from time to time. 

By signing this document, you certify that, to the best of your knowledge, the below responses and all information provided by you related to this Professional Conduct Disclosure Form are truthful, accurate, and complete, and you agree to notify ESA promptly of any material changes required in your responses to the below question. You acknowledge that failure to comply with ESA’s policies may result in your ineligibility to receive, or revocation of, any ESA award, honor, other type of ESA recognition, or governance position, and is grounds for potential sanctions against you. 

Responding “No” means that you are unaware of any such action against you. Responding “Yes” means that you are aware of an action against you. This is not necessarily a barrier to your participation in this or future ESA activities, and responding “yes” and signing this document is not an admission of guilt – it is merely an acknowledgement of knowledge of a filed accusation. Responding “yes” will start a process that begins with a confidential one-on-one discussion with ESA’s Executive Director of the details of the complaint.
Disclaimer
Nominee's failure to complete the Professional Conduct Disclosure by the specified deadline will result in their name being withheld from the election ballot.