I hereby affirm that the information contained herein is true and correct. I hereby grant permission to the Greater Eastside Alliance, Inc. to verify such information and to release information.
I understand that receipt of this scholarship grant is contingent on continued enrollment, and completion of Certificate Program. Falsification of any information or failure to meet these requirements will result in the termination of my scholarship and I will be obligated to return any grant monies already received.
I hereby grant and assign the Greater Eastside Alliance, Inc. the right to use my biographical information, essay response, and my image to publicize my nomination and/or receipt of this scholarship award, and to promote the goals of the scholarship, for editorial, trade, advertising or any other purpose and in any manner and medium, including website and internet promotion.
I also consent to have a copy of my application and all supporting materials retained indefinitely by the Greater Eastside Alliance, Inc.