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Bursary Application Waiver

I, ,

hereby acknowledge and agree that:

The information provided on the application is true to the best of my knowledge
The CPABC has not had any part in selecting the institution referred on the application
Any decision by CPABC to award a bursary to me will not constitute a representation or warranty by CPABC that the institution referred on the application is appropriate or suitable for me in any particular respect
CPABC shall not incur any liability in connection with my attendance at the institution
All arrangements for my attendance at the institution are my responsibility.

I am 18 years or older.

I am under 18 years and will have my parent / guardian sign this form.

Parent / Guardian Name:

By signing below, I certify all information is true and correct to the best of my knowledge.

Leave this empty:

Your legal name

Your email address

Please Confirm full name and signature.

Draw your signature with your mouse, tablet or smartphone Clear

I agree that I am and I agree this is a legal representation of my signature for all purposes just the same as a pen-and-paper signature

I agree that I am and I understand this is a legal representation of my signature

Timestamp

Audit

July 5, 2020 11:16 pm PDT

Bursary Application Waiver Uploaded by Denzil Muncherji - programs@bccerebralpalsy.com IP 23.16.74.222