Statement of Assurances

Statement of Assurances
Applicants
Initial Board of Trustees
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Our signatures below attest to the full compliance with all of the requirements of Article 56 of the Education Law, including, but not limited to, the following:

We the undersigned hereby certify that all of the information provided herein is true and accurate, to the best of our knowledge. We understand that if any of the information contained herein is found to have been deliberately misrepresented, that may constitute sufficient grounds for the refusal or revocation of a charter. We further certify that we will comply with all of the assurances set forth herein, and respectfully request the issuance of a charter.

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APPLICANTS

_______________________________________
Print/Type Name

_______________________________________
Signature

Sworn to before me this _____ day of _______________ 20__

_______________________________________
Notary Public

 

________________________________________
Print/Type Name

________________________________________
Signature

Sworn to before me this _____ day of _______________ 20__

________________________________________
Notary Public

 

________________________________________
Print/Type Name

________________________________________
Signature

Sworn to before me this _____ day of _______________ 20__

________________________________________
Notary Public

 

________________________________________
Print/Type Name

________________________________________
Signature

Sworn to before me this _____ day of _______________ 20__

________________________________________
Notary Public

 

________________________________________
Print/Type Name

________________________________________
Signature

Sworn to before me this _____ day of _______________ 20__

________________________________________
Notary Public

 

________________________________________
Print/Type Name

________________________________________
Signature

Sworn to before me this _____ day of _______________ 20__

________________________________________
Notary Public

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INITIAL BOARD OF TRUSTEES

__________________________________________
Print/Type Name

__________________________________________
Signature

Sworn to before me this _____ day of _______________ 20__

__________________________________________
Notary Public

 

__________________________________________
Print/Type Name

__________________________________________
Signature

Sworn to before me this _____ day of _______________ 20__

__________________________________________
Notary Public

 

__________________________________________
Print/Type Name

__________________________________________
Signature

Sworn to before me this _____ day of _______________ 20__

__________________________________________
Notary Public

 

__________________________________________
Print/Type Name

__________________________________________
Signature

Sworn to before me this _____ day of _______________ 20__

__________________________________________
Notary Public

 

__________________________________________
Print/Type Name

__________________________________________
Signature

Sworn to before me this _____ day of _______________ 20__

 __________________________________________
Notary Public

 

___________________________________________
Print/Type Name

___________________________________________
Signature

Sworn to before me this _____ day of _______________ 20__

___________________________________________
Notary Public

 

___________________________________________
Print/Type Name

___________________________________________
Signature

Sworn to before me this _____ day of _______________ 20__

___________________________________________
Notary Public

 

___________________________________________
Print/Type Name

___________________________________________
Signature

Sworn to before me this _____ day of _______________ 20__

___________________________________________
Notary Public

 

___________________________________________
Print/Type Name

___________________________________________
Signature

Sworn to before me this _____ day of _______________ 20__

___________________________________________
Notary Public

 

___________________________________________
Print/Type Name

___________________________________________
Signature

Sworn to before me this _____ day of _______________ 20__

___________________________________________
Notary Public

 

___________________________________________
Print/Type Name

___________________________________________
Signature

Sworn to before me this _____ day of _______________ 20__

___________________________________________
Notary Public

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