Ethics Programs

The Ethical Practices Institute

has your solution for ethics programs

and ethics training.

 

Need an Ethics Program? : Click here: Plan Options

 

INFORMATION REGARDING APPLICANT

Name of Organization:

Principal Address:

City:

State:

Zip:

Phone:

Primary Line of Business:

Number of Full-Time and Part-Time Employees:

Subsidiary Companies:

Date of Plan Adoption:

MM DD YYYY

Primary Contact :


First Last

Person Responsible for this program (to be named Ethics Officer):


First Last


Email, Phone

Contact name(s)of the persons to be used to report ethical violations and concerns:


Name, Email, Phone


Name, Email, Phone


Name, Email, Phone

Method of Payment:

Bill me: Purchase Order #

Charge to Credit Card #:

Expiration Date:

MM DD YYYY

THE UNDERSIGNED AUTHORIZED AGENT OF THE APPLICANT DECLARES THAT TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF, THE STATEMENTS SET FORTH HEREIN ARE TRUE AND COMPLETE. IF THE INFORMATION IN THIS APPLICATION CHANGES PRIOR TO THE INCEPTION DATE OF THE PLAN, THE APPLICANT WILL NOTIFY THE COMPANY OF SUCH CHANGES.

IT IS AGREED THAT THIS APPLICATION, INCLUDING ANY MATERIAL SUBMITTED THEREWITH, SHALL BE THE BASIS OF THE PLAN. THE COMPANY WILL HAVE RELIED UPON THIS APPLICATION, INCLUDING ANY MATERIAL SUBMITTED THEREWITH, IN ISSUING THE PLAN.

THE APPLICANT DOES HEREBY FORMALLY ADOPT AN ETHICAL PRACTICES PROGRAM ADMINISTERED BY THE ETHICAL PRACTICES INSITUTE.

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A

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© 2005 Ethical Practices Institute