I declare that my information on the above form is true and correct to the best of my knowledge. I also confirm that in the event that any information provided by me is not true I will forfeit/reimburse the awarded compensation that I received as a result of my providing the erroneous information.
I authorize OUTbio to collect, receive, store, transfer, and use any information provided by me, or any information obtained in connection with this application, and to disclose such information to all participating institutions.
I authorize OUTbio to verify any information provided and obtain available official records from any educational institution attended by me. I understand that OUTbio is not responsible if an institution does not provide these records.
I understand that OUTbio may decline to assess my qualifications if the information required for a valid assessment is not available to OUTbio.
If awarded, I authorize OUTbio to publish and post information about me, including my picture to announce the award on its website and other organization publications.