Please complete this form to disclose any potential conflicts of interest that may arise while serving as a judge for the Australian Museums and Galleries Awards. As a judge, it is essential to maintain transparency and integrity throughout the assessment process to ensure fairness and impartiality.

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* 1. Are you currently affiliated with any museum or gallery that has been nominated for the Australian Museums and Galleries Awards?

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* 2. Have you served as an employee, contractor, consultant, or advisor to any museum or gallery that has been nominated for the Australian Museums and Galleries Awards within the last two years?

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* 3. Do you have any indirect financial interest in any of the museums or galleries that have been nominated for the Australian Museums and Galleries Awards?

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* 4. Are you related to any person(s) who are associated with a museum or gallery that has been nominated for the Australian Museums and Galleries Awards (e.g., immediate family members, close relatives, or significant others)?

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* 5. Have you received any gifts, sponsorships, or other benefits from any of the museums or galleries that have been nominated for the Australian Museums and Galleries Awards in connection with your role as a judge?

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* 6. Is there any other potential conflict of interest that you believe could impact your ability to impartially judge the entries for the Australian Museums and Galleries Awards?

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* 7. Additional comments:

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