CONFLICT OF INTEREST QUESTIONNAIRE

For vendor or other person doing business with local governmental entity

By law this questionnaire must be filed with the records administrator of the local government not later than the 7th business day after the date the person becomes aware of facts that require the statement to be filed. See Section 176.006, Local Government Code.

A person commits an offense if the person violates Section 176.006, Local Government Code. An offense under this section is a Class C misdemeanor.

Date Received

       Bonnie A. Lesley, President, Creative Education Institute, Inc.

                Check this box if you are filing an update to a previously filed questionnaire.

                  (The law requires that you file an updated completed questionnaire with the appropriate filing authority not later than

                       September 1 of the year for which an activity described in Section 176.006(a), Local Government Code, is pending and

                       not later than the 7th business day after the date the originally filed questionnaire becomes incomplete or inaccurate.)

       Describe each affiliation or business relationship with an employee or contractor of the local governmental

       entity who makes recommendations to a local government officer of the local governmental entity with

       respect to expenditure of money.

 None

        Describe each affiliation or business relationship with a person who is a local government officer and who

        appoints or employs a local government officer of the local governmental entity that is the subject of

       this questionnaire.

 None

CONFLICT OF INTEREST QUESTIONNAIRE

For vendor or other person doing business with local governmental entity

         Name of local government officer with whom filer has affiliation or business relationship. (Complete this section

         only if  The answer to A, B, or C is YES.)

       
        This section, item 5 including subparts A, B, C & D, must be completed for each officer with whom the filer has

           affiliation or business relationship. Attach additional pages to this Form CIQ as necessary.

A.       Is the local government officer named in this section receiving or likely to receive taxable income from the filer

        of the  questionnaire?

                                            Yes            X           No

B.       Is the filer of the questionnaire receiving or likely to receive taxable income from or at the direction of the

         local government  officer named in this section AND the taxable income is not from the local governmental entity

                                           Yes            X            No

C.      Is the filer of this questionnaire affiliated with a corporation or other business entity that the local government officer

        serve as an officer or director, or holds an ownership of 10 percent or more?

                                             Yes              X         No

          D. Describe each affiliation or business relationship.

          Describe any other affiliation or business relationship that might cause a conflict of interest.

  None

                Signature of person doing business with the governmental entity                                                Date