Summary: UNIVERSITY OF REGINA
Faculty of Graduate Studies and Research
North Residence, NR 110.2
University of Regina
Canada S4S 0A2
Fax: (306) 337-2444 Email: firstname.lastname@example.org
Conflict of Interest Declaration for Members of the University
Staff as Candidates for Graduate Programs
After reviewing the policy document concerning "Members of University Staff as Candidates for
Graduate Programs", I declare that I am unaware of any conflict of interest within my program
of studies, ________________________, with regards to my employment as a
________________________ in the ________________________ department/area. Should
any conflicts appear in the future, I will bring them to the attention of the Dean of the Faculty of
Graduate Studies and Research immediately.
I am aware of a possible conflict of interest and request a meeting with the Dean of the
Faculty of Graduate Studies and Research to discuss matters.