PLEASE READ THE FOLLOWING STATEMENT:
I understand that any material false statement made knowingly and
willfully by me on this application, or any documents attached
hereto may, in accordance with O.C.G.A. 16-10-71, which provides
that upon conviction, a person who knowingly commits the offense of
false swearing shall be punished by a fine of not more than $1,000
or by imprisonment for not less than one nor more than five years,
or both, subject me to prosecution in a court of law. Additionally,
I further understand than any such false statement may subject me to
immediate dismissal from the institution.
Further, I certify that, to the best of my knowledge, the
information submitted on this application is true and complete.