Please sign below after reading and confirming.
Certification: I understand that any material false statement made knowingly and willfully
by me on this application, or any documents attached hereto may, in accordance with
O.C.G.A .16-10-71, which provides that upon conviction, a person who knowingly commits
the offense of false swearing shall be punished by a fine of not more than $1,000 or by
imprisonment for not less than one nor more than five years, or both, subject me to
prosecution in a court of law. Additionally, I further understand that any such false statement
may subject me to immediate dismissal from the institution. I understand that any
information provided during the application process may be used by TLC Butterfly Effect
Academy in obtaining a criminal history check. I understand that this background check may
affect my admissions to SGSC. Further, I certify that, to the best of my knowledge, the
information submitted on this application is true and complete.
***Only complete forms can be processed. Incomplete forms may result in an administrative
delay due to lack of information