I, (Applicant Signatory Name)*, (Signatory Title)*, certify that (Applicant Organization Name)* is a local entity organization that:Is legally organized under the laws of Iraq or federal Iraq; Has its principal place of business or operations in the Kurdish Region of Iraq or federal Iraq; Is majority-owned by individuals who are citizens or lawful permanent residents of Iraq; Is managed by a governing body, the majority of whom are citizens or lawful permanent residents Iraq;* And is a [select one]:Youth-led organization whose Chief Executive Officer or other leaders are under the age of 35, and whose Board of Directors are predominantly under the age of 35. Youth-serving organization that has a mission, mandate, or programs with an expressed priority of serving or supporting youth under age 35.*
Organizations led by or serving marginalized groups, which may include age, gender, disability, ethnicity, sexual orientation, and other identities, are encouraged to apply. Please indicate if your organization is a "female-led organization whose Chief Executive Officer or other leaders are female, and whose Board of Directors are predominantly female." Yes No I First Name* Last Name* on behalf of Applicant Organization* hereby confirm that all of information submitted is true and I understand that issuance of false information will lead to the automatic disqualification of my application. Signature* Title* Organization* Date*