I, (Applicant Signatory Name and Title), certify that (Applicant Organization Name), is a local entity that: Is legally organized under the laws of Country Has its principal place of business or operations in Country Is majority-owned by individuals who are citizens or lawful permanent residents of Country Is managed by a governing body, the majority of whom are citizens or lawful permanent residents of Country And is: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, and who has a mission, mandate, or programs with an expressed priority of serving or support youth under age 35. Youth-serving organization that has a mission, mandate, or programs with an expressed priority of serving or supporting youth under age 35. And is a (choose all that apply):A female-led organization whose Chief Executive Officer or other leaders are female, and whose Board of Directors are predominantly female. An organization with a specific mission to work with marginalized groups (e.g. LGBTQI+, Youth with disabilities) An organization with a specific mission to work with vulnerable youth (e.g. youth in conflict areas, youth living with HIV/AIDS or orphaned as a result of HIV/AIDS) I acknowledge that responses to Annex 1. Part B. Questions 1-9, except for any confidential or proprietary information contained in the questions marked below, may be shared at the discretion of Youth Excel for the purpose of this grant competition. The following questions contain confidential or proprietary information (check all that apply): Question 4 Question 5 Question 6 Question 7 Question 8 Question 9 Signature Title Date