MEMBERSHIP REGISTRATION

If you are interested in becoming a member of the Gordian Fund, please complete all of the Membership Registration information below, then click "Submit".

If you prefer you may download a printable version of the Membership Registration form and Conflict of Interest form and mail the completed form to the Gordian Fund at 4545 S. Monaco Street, Unit 139, Denver, CO 80237.

PERSONAL INFORMATION
First Name*
Last Name*
Birthdate
CONTACT INFORMATION
Email*
Email 2
Mailing Address*
City*		State*
Zip Code*
Home Phone
Cell Phone
Work Phone
EMPLOYMENT INFORMATION
Occupation
Employer
Title
Years with Company
EDUCATION INFORMATION
High School		Year
College		Year
Graduate School		Year

CONTRIBUTION COMMITMENT
Please indicate your five-year contribution commitment*
Platinum - $5,000
Gold - $2,500
Silver - $1,000
Copper - $500

CONFLICT OF INTEREST STATEMENT

Definition

“Conflict of interest” as referred to within the Gordian Fund Bylaws, shall include but not be limited to, any transaction by or with the Gordian Fund in which a member (or any affiliate of the member) has a direct or indirect personal interest, or any transaction in which a member is unable to exercise impartial judgment or otherwise act in the best interest of the Gordian Fund.

Board Review

In the event any member of the Gordian Fund has a conflict of interest that might properly limit the member’s fair and impartial participation in fund deliberations or decisions, that member shall inform the board as to the circumstances of such conflict. If those circumstances require the nonparticipation of the affected member, the board may nonetheless request from the member any appropriate non-confidential information which might inform its decisions.

Voting and Self-Dealing

No member shall cast a vote, nor take part in the final deliberation in any matter in which he or she, members of his or her immediate family, or any organization to which trustee has allegiance, has a personal interest that may be seen as competing with the interest of the Gordian Fund. Any member who believes he or she may have such a conflict of interest shall so notify the board prior to deliberation on the matter in question, and the disinterested voting members shall make the final determination as to whether any member has a conflict of interest in any matter. The minutes of the meeting involved shall reflect disclosure of any conflict of interest and the recusal of the interested member(s).

Pursuant to the Gordian Fund’s Conflict of Interest Policy requiring disclosure of certain interest, a copy of which has been furnished to me, I hereby state that I or members of my immediate family do not have:

• a current or potential involvement in a financial or other relationship that directly and significantly affects, or potentially could affect my independent, unbiased judgment in my duty to the Gordian Fund;
• possession of a significant ownership interest or management functions in an organization conducting business with the Gordian Fund;
• Potential for material, financial, or other benefit from knowledge of information confidential to the Gordian Fund.

Exceptions to the above statement are noted as follows:


Organizations or companies with which I am currently involved as an officer, employee or Board member:


This agreement is between the Gordian Fund and the undersigned. By electronically signing this document, I agree to participate in the Gordian Fund. The term of the contribution will be for five years and I agree to pay total sum of contribution within that period. I acknowledge that four of a cycle's five years, I will be required to give a minimum of 5% of my commitment per year, as long as the full financial commitment is fulfilled within the five-year term. I hereby acknowledge that failure to meet contribution requirements or deadlines will result in a review by the Board of Directors and possibly a vote of dismissal by the membership. Any member whom the membership dismisses or whom voluntarily resigns shall be expected to fulfill his pledge. Membership benefits may be suspended until fulfillment occurs. The Gordian Fund reserves a reasonable right to refuse any gift that threatens the values and mission of the organization. The membership reserves the right to change the contribtion commitment at any level at any time for future contributions.

Please enter your first and last name to indicate that you have read and understand the above terms*

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