Seguridad

Application Signature Page for Application # 145030 INITIAL HERE--> _____ I authorize Step Up for Students to use my personal, financial, and student's educational information for determining mystudent(s) eligibility and to share said information with appropriate state agencies and legal authorities as needed to make such a determination. INITIAL HERE--> _____ I certify that all the informationprovided in this application and all supporting documentation is true, correct and complete and that ALL household income has been reported. I understand that I can be lawfully punished for fraud andmay have a scholarship denied or revoked if I intentionally misrepresent this information. INITIAL HERE--> _____ I certify that no parent/guardian of a child on this application is an owner, operator,principal, or person with equivalent decisionmaking authority of an eligible private school. INITIAL HERE--> _____ I agree to follow the rules and responsibilities for parents as they apply to theprogram as set forth in the Parent Handbook. INITIAL HERE--> _____ I authorize Step Up for Students to check with all federal, state, and local programs for additional scholarship eligibilityinformation that would assist my application for a tax credit scholarship. This authorization would extend to the National School Lunch Program (for free and reduced lunch eligibility and/or food stampeligibility), and others, as appropriate. Any information collected will only be used for assisting eligibility determination for this program and will not be shared with any other entity or program. Iunderstand that failing to authorize this search will NOT affect my eligibility or participation in the tax credit scholarship program. However, it may require me to produce documents that might otherwisebe available and slow down the time needed for eligibility determination.
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Signature Primary Parent/Guardian

Signature...