1. Section 1001 of Title 18 of the U.S. Code provides that knowingly falsifying or concealing a material fact is a felony that may result in fines of up to $10,000 or 5 years in prison or both. By submitting this training request form, I am certifying that the information provided in each and every electronic entry on this training request form is true and complete to the best of my knowledge and ability.
2. I further certify that I am the individual whose name is on this training request form being submitted. I understand that this is a legally binding document, that my agreement (by clicking the box marked "I Agree" below the declaration against perjury which follows this paragraph) constitutes an electronic signature, and that any false, misleading, or incomplete statements by me in response to any part of this submission constitutes a violation of federal law and may lead to criminal prosecution or other legal action.