I certify that I have provided complete and accurate responses to the items on this application. I further certify all documents submitted to support this application are authentic and unaltered records that pertain to me. I certify that I will use scholarship funds for educationally related expenses. If approved for the loan repayment program, I agree to notify QueensCare and / or its designee within 10 days if my current employment is terminated or my status changes from full time. My signature certifies the accuracy and completeness of the information provided. I understand that any misrepresentation may be cause for denial or cancellation of awards offered or granted. I also understand that all scholarships or loans given to me must be claimed within one year of being awarded.