The undersigned certifies that the information provided is complete and accurate. The undersigned agrees to provide supporting documentation to verify the information in this application, including financial records. By submission of this application, the undersigned agrees to allow BOMI International to publish their name as the award recipient in promotional materials should they be selected to receive the scholarship award. The undersigned further agrees to indemnify and hold harmless BOMI International, its directors, officers, employees, agents, and committee members from any and all claims arising out of the application, selection, or participation in this scholarship program. The undersigned also authorizes and consents to representatives of BOMI International contacting those persons or institutions listed on this application and its attachments for purposes of verification of the information contained herein.