Truth of Information/Release (To be completed by nominee)
The information provided is true and complete to the best of my knowledge and belief. I agree that if I am selected as a Asian American Leadership Award recipient, I hereby authorize the release and use, in connection with the Asian American Leadership Awards program of my name, company name, likeness, recording of my voice and photographs, including video tapes or other forms of media, which may be taken of me, and I agree that no compensation shall be due me or my company for such usage. I acknowledge and agree that any misrepresentation of the information provided will be grounds for denial of this nomination. All financial information shall remain confidential.