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of <br />• <br />40 <br />40 <br />t DOW St48tures <br />I certify that the information provided on this form is true and accurate to the best of my knowledge. I <br />Understand that prior to any grant award, the applicant must comply with all application and program <br />requirements of the Public Safety Partnership and Community Policing Act of 1994 and other requirements of <br />Federal law. <br />Lar► Enforcement Gxceutive's Signature: <br />Date:T—f1� <br />fsrnarum of per nonred ur .Bret ort 11 of thus form) <br />Government Executive's Signature: <br />Date: 06--13-2000 <br />fsi ,nature of person +rased in Section 11 of this firm} <br />Fran B. Adams, Chairman <br />School Official's Signature: <br />Date: <br />(signa[ure n rson Homed rn�;,,mntion) <br />VL Appiicstfan Sub0slln lnstructiuns <br />Please return 1 original and i copies of all application materials that are being submitted with this request for <br />funding. This includes: <br />t the Application Form; <br />■ the Community Policing Information Worksheet (for first time COPS Applicants); <br />■ the Budget Information forms; <br />■ Assurances; <br />■ Certifications; <br />• a written Detention Plan; <br />• the Memorandum of Understanding; <br />• the COPS in Schools Narrative Information. and <br />• any additional information (example: additional information questionaire for certain police agencies) that, <br />is required. <br />09 COPS ill schools &fXW <br />