I hereby certify that all of the information provided by me in this application (or any other accompanying or required documents) is correct, accurate, and complete to the best of my knowledge. I understand that the falsification, misrepresentation, or omission of any facts in this document is cause for denial of services or immediate termination of current services, regardless of the timing or circumstances of discovery. In the event that service is terminated, payment will still be owed in full.

I understand that the submission of this application does not guarantee services.