diff --git a/Conflicts/conflict-of-interest-policy.md b/Conflicts/conflict-of-interest-policy.md
index b1653349a59488ebc0ac99eaafb5d1ea5265ef77..4ee102455153392fbe2876f3b810b07af28e4a11 100644
--- a/Conflicts/conflict-of-interest-policy.md
+++ b/Conflicts/conflict-of-interest-policy.md
@@ -372,12 +372,10 @@ Chairperson of Conservancy's Board and to Conservancy's General Counsel.
 
 Date: `__________________________`
 
-Next Form to be completed by (six months from now):
+Next Form to be completed by (six months from now): `__________________`
 
 Name: `__________________________`
 
-Date: `__________________________`
-
 Position (employee/officer/trustee): `_________________________________`
 
 I affirm the following: