Fillable Printable Affidavit of Financial Support - Calhoun Community College

Affidavit of Financial Support - Calhoun Community College

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Affidavit of Financial Support

For

Admission to Calhoun Community College

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NOTE: Colleges and Universities in the United States are required to have documentation of adequate financial support

before they may legally admit an international student for study. Proper completion and submission of this form by the

financial sponsor with adequate bank statements are required.

This form must be TYPED or PRINTED clearly in INK

INSTRUCTIONS: This form is to be completed by prospective STUDENTS’S FINANCIAL SPONSOR ONLY.

1. Studen t ’s Name: _____________________________ _______________________________________

(Family Name in Capital Letters) (First) (Last)

2. Sponsor ’s Name:__ _______________________ _______________________________________ ____

(Family Name in Capital Letters) (First) (Last)

3. Mailing Address of Sponsor: ____ _________ ________________________ _____________________

4. Relations hip to Studen t:________________________ 5. County of Birth:______________ _________

6. Date of Birth: ________________ _________ __7. Country of Citizenship____________________ ___

(Month) (Day) (Year)

8. Employer of Source(s) of income and net amount (U.S. Dollar) received per year.

_________________________________________ $ _______________________________________

9. Position or Job Title:_________________________________________________________________

10. Person s d ep end ent upon sponsor for financial support (other than prospective student):

Name of Person Age Relationship

__________________ ________ _____________ ________

_______________ ___ ________ _____________________

__________________ ________ _____________ ________

11. Number of persons named above who are or w ill be studying in the United States: ________________

12. Does your government re quire you to obtain their permission in order to transfer funds to the U.S. to

financially support the prospective stud ent? YES ________________ NO ___ ___________________.

If “YES”, please list the documents you will need from Calhoun Community College to obtain the required

permission:_________________________________________________________________.

13. Calhoun Community College has a policy which prohibits students from registering for classes unless

the studen t p ays all tuitio n and fees at reg istratio n. Do you anticip ate an y diff iculty in assu ring th at th is pro spectiv e

student will have sufficient funds in his/her possession at each registration YES__________ NO __________.

DECLARATION BY FINANCIAL SPONSOR

I, __________________________________________________ financial guarantor for

_____________ ________________________ __________certify that I will prov ide funds to pay for ANY

(Print Prospective Student’s Name)

and ALL educational and living expenses of the above named prospective student, and certify that the prospective

student WILL NOT become a public charge during his/her stay in the United States of America.

I am aware that the official MINIMUM estimation of the total cost of an international student

attending Calhoun Community College for the 2012-13 academic year is: $10, 845.00 (U.S.) for a dependent

student. (Please Check)

Sponsor ’s Signature:_______________________ _______________ Date: ________________________ __

SIGNATURE MUST BE NOTARIZED BELOW:

DECLARATION BY SPONSOR’S BANK

Name of Sponsor__ _______________________ ________________________ _______________________

(Family Name in Capital Letters) (First Name) (Middle)

Date: (Month, Day, Year): ________________________________________________________________

This is to certify that, in view of our pro fessional relationship with the above named client, who has had an account

and/or cond ucted other business transactio ns through this bank for ____________ years, it is our conviction that he/she

has sufficient financial means to provide at least the amount of money indicated in the top part of this p age to the above

named prospective student for the purpose of studying in the United States of America. Further, to the best of our

knowledge, he/she should experience no difficulty in transferring the required funds from our country to the student in

the United States.

It is understood that this DECLARATION is being made without incurring any risk, obligation or responsibility on the

part of this banking institution.

Signa ture of Bank Official:_______________ ________________________ _________ _________ _______

Printed Name of Bank Official:_____________________________________________________________

Name of Bank: ______________________________________________________ ___________________

Address of Ban k:_______ _________ _________ ___________Phone Number of Bank______________ __