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<br />COPS in Schools Application Forms <br /> <br />I understand that prior to any grant award, the applicant must comply with all <br />application and program requirements of the Public Safety Partnership and <br />Community Policing Act of 1994 and other requirements of federal law. In <br />addition, my signature certifies that this application requests funding only for <br />positions that would not be otherwise funded in my agency's budget with <br />state, local or Bureau of Indian Affairs funds. <br /> <br />By signing below, I certify that the information provided on this form and the <br />attached forms is true and accurate to the best of my knowledge. I understand <br />that faIse statements or claims made in connection with COPS grants may <br />result in fines, imprisonment, debarment from participating in federal grants <br />or contracts, and/or any other remedy available by law to the federal <br />government. <br /> <br />It is not permissible for someone to sign application forms in place of the law <br />enforcement and/or government executives named in the application. <br />Applications with missing, incomplete, or inaccurate signatures or responses <br />may not be considered fur funding. Stamped or ele-ctronic signatures also witl <br />not be accepted. <br /> <br /> <br />Date: 5 -/1- 0,/ <br /> <br />Date: 7)r)y <br /> <br />Date:s} 1/1) t( <br /> <br />Section III "Partner Information" as the designated <br />t program and the required training.) <br /> <br />(Signature of person named un <br />School Representative for this gr <br /> <br />Please return one orieinaJ and two copies of all application materials. <br />Please be sure to include all forms as outlined in the CIS 2004 <br />Application Checklist and any additionaJ information necessary to <br />complete this request for grant funding. Completed application forms <br />should be mailed to: <br /> <br />COPS in Schools Control Desk <br />U.S. Department of Justice, COPS Office <br />1100 Vermont Avenue, N.W. <br />7th floor <br />Washington, D.C. 20530 (please use 20005 zip code for overnight mail) <br /> <br />8 <br />