By signing below, I certify, acknowledge, and agree to the following:
- There is no fee for review and determination of Request for Assistance Form, nor does review and determination of Request for Assistance mean services or aid is rendered or implied.
- Additional information may be requested and acquired to complete review and determination.
- Tribal preference may apply to Arrowhead Incubator’s resources.
- Before services are aid rendered, the recipient will complete and sign an Agreement for Assistance.
All the answers I have given on this application, and responses, are complete and accurate to the best of my knowledge. I understand that falsification or omission of information or credentials may be cause for; the refusal of admission, cancellation of admission, or suspension or dismissal from the program if discovered subsequently. I also understand that misuse of any funds or services provided may be cause for repayment of funds or services and/or prosecution under the law. I also understand that I have a continuing obligation to notify Arrowhead Incubator in writing of a change in my circumstances that would have resulted in a different response to the above questions. Failure to update Arrowhead Incubator in writing about said changes in circumstances may result in the same sanctions as apply to misrepresentation of the facts originally stated.