APPLICANT CERTIFICATION STATEMENT
I certify that the information on this application is accurate to the best of my knowledge. I understand that my willful misstatement of the facts may cause my forfeiture of rights in the Green Cadre Program and may result in criminal action. I give permission for outside sources to be contacted and for them to disclose any information necessary to verify my eligibility for Green Cadre. I further understand and agree that my social security number and other information on this application will be provided to other government agencies as required by law.