Applicant
Referee
Referee Contact
Reference
Confirmation

I declare that the information given in this reference is, to the best of my knowledge, correct.

Any misrepresentation may result in a penalty which could include, but is not limited to, ineligibility to be considered for future bursaries and forfeit of any outstanding bursaries.

I authorize the JIBC Registration Office to verify any or all of the above statements if deemed necessary.

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