I, the parent of the scholarship applicant, declare that, to the best of my knowledge, the information provided on this form is correct and complete, and I certify that the information regarding my employment by a company that is a member of the Maryland DC Delaware Broadcasters Associations is true and correct. I consent to the use of the information provided on this form in connection with the scholarship program and consent to the release of publicity about my child if my child is the recipient of the scholarship.
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