I certify that the information provided on this document is true and accurate to the best of my knowledge and belief. I understand that such information is subject to verification and further understand that the above information, if misrepresented or incomplete, may be grounds for immediate termination from any ARPA program and/or penalties as specified by law.
This form is submitted digitally and remitted to Pathways To Excellence, Inc.
Pathways To Excellence will make this information available to WorkSource Montgomery, who may verify your participation in Pathways To Excellence, Inc's programs and activities.
Erica RobertsExecutive DirectorPathways To Excellence, Inc.