I hereby acknowledge that all information provided or shall be provided by me in this form or through any other supporting documents are true and accurate and Yayasan DayaDiri shall be at liberty to decline my application herewith if any information provided by me is found to be false and inaccurate.
I understand that as part of the scholarship application process, Yayasan DayaDiri may conduct a background check on me. As such, I hereby authorize Yayasan DayaDiri and its representatives to obtain relevant information pertaining to myself from any party who has information about me.
It is expressly understood that any information given by any party mentioned above is to be used solely for the purpose of my scholarship application to Yayasan DayaDiri. I shall release all parties who have provided information for the purpose of my background checking from any liability.
Should I be offered a scholarship from Yayasan DayaDiri, I hereby agree to extend my consent and agreement contained herein for the period that I remain a scholarship recipient of Yayasan DayaDiri.
This form may be reproduced in Portable Document Format (PDF), photocopied or facsimile, and the reproduced form shall be binding on me as the original.
By signing below, I hereby acknowledge that I have read, understood, and agree to the above statement(s).