Individual Application Form

I certify under oath or affirmation that the information provided herein is true, complete and accurate to the best of my knowledge
and belief. If this grant is awarded, the proceeds thereof will be used solely for the purposes described in this application. No portion of the proceeds will be used to benefit any organization or individual supporting terrorism or for any other unlawful purpose, and that verification and/or documentation of the aforesaid will be provided promptly upon request.