Fillable Printable Affidavit of Financial Support Form - New Jersey

Affidavit of Financial Support Form - New Jersey

STUDENT’S NAME ______________________________________________________________________________________________

Please type or print clearly in ink.

All international students who will require an F or J student visa must complete the statement below. The University

requires documentation certifying the validity of the financial resources listed on this sheet.

In addition to this affidavit, students

must show proof of finances for the first year of intended study

. This evidence should consist of:

1. An official bank statement on original letterhead stationery and dated within the last six months that proves sufficient

funds are available; or

2. A statement of support from a sponsor, along with evidence of the sponsor’s financial resources

in the form of an official bank statement; or

3. An official letter of award from your government or other sponsoring organization indicating the terms of the support.

PHOTOCOPIES, SCANNED DOCUMENTS AND FACSIMILES ARE NOT ACCEPTED. All documentation must be current and

in U.S. dollar amounts. Solvency certificates are not accepted.

I. Estimated Cost – Academic Year (August-May)

The estimated annual cost for the 2009-2010 academic year is as follows:

The above example is for planning purposes only. Official bills for tuition and fees will be presented at registration. Some

courses require additional fees. The University reserves the right to change any of the above expenses without prior notification.

This estimate does not include personal expenses such as transportation, clothing, books, laundry and entertainment.

II.

Estimated Cost – Summer School

(May-August)

The estimated annual cost for the 2010 Summer School is as follows:

UNDERGRADUATE (Both Campuses) GRADUATE (Both Campuses)

Tuition (9 credits), Fees .................. $7,968 Tuition (9 credits), Fees .................. $9,444

Room,

Board Expenses

.................. 4,608 Room, Board Expenses .................. 4,608

TOTAL $12,576 TOTAL $14,052

If you attend summer school or have your dependents join you, sufficient financial support must be demonstrated through

your financial documents

Add an additional $1,500 for off-campus housing.

Important Note: The expenses listed in Section I and II above reflect current aver

age cost of living allowances for this metropolitan area.

Expenses may vary according to each

student. This presentation is only an approximation.

III. Dependent Cost (Wife or husband and children)

The cost for a dependent is calculated for a twelve (12) month year. The amount of money below indicates the amount

necessary to support a dependent:

Each adult dependent ................... $7,500 Each child dependent .................... $4,000

I intend to have _________ (number) of dependents accompany me to the U.S. (This information is required on the I-20 Form.)

Dependents’ Name (LAST, FIRST) Date of Birth (MO/DAY/YR) Country of Birth Relationship

___________________________________________________________________________________________________________________

(Continued on next page)

Affidavit of Financial Support for

International Students

UNDERGRADUATE ....... METROPOLITAN COLLEGE AT

.................................................. CAMPUS FLORHAM

Tuition & Fees ................ $30,576 $32,774

Room, Board Expenses... 11,500 11,500

TOTAL $42,076 $44,274

GRADUATE

(Both Campuses)

Tuition (18 credits) & Fees ........... $19,908

Room, Board Expenses .............. 11,500

TOTAL $31,408

IV. Specific Sources and Amounts of Support

Please list below the specific sources and amounts of support (attaching the previously requested supporting documentation). The

amounts must reflect funding for the entire period of study. Please attach detailed information.

SOURCE AMOUNT

Personal Savings ____________________________________ _______________________________

Family _

___________________________________ _______________________________

Government Grant or Stipend ____________________________________ _______________________________

Scholarships (Source and Duration) ____________________________________ _______________________________

Loans (Source) ____________________________________ _______________________________

Other Means (Describe Fully) ____________________________________ _______________________________

TOTAL $ _________________________________

In signing my name to this affidavit, I swear that the information provided is an accurate statement of my plans

to finance my studies.

Student’s Name (PLEASE PRINT) ___________________________________________________________________________________________

Signature _______________________________________________________________________________ Date ____________________

Signature of Notary Public or Public Authority ________________________________________________ Date ____________________

Affix Official Seal or Notary Stamp Here

V. Sponsor Certification

This is to certify that I, ___________________________________________________________________________________________________ ,

will sponsor the above-named student for the period of

___________ to ___________ while he/she is enrolled, in the relationship of

(relative, friend, etc.)

______________________________________________________________________ . This sponsorship relieves the

officials of Fairleigh Dickinson University of any and all responsibilities for the financial well-being of the student.

Sponsor’s Name (PLEASE PRINT) __________________________________________________________________________________________

Signature _________________________________________________________________________________ Date ____________________

Address ___________________________________________________________________________________________________________

City/State __________________________________________________________________________________________________________

Country ________________________________________________ Zip/Postal Code ____________________________________________

All documents and forms should be sent to:

Office of International Admissions, Fairleigh Dickinson University, 1000 River Road, T-KB1-01, Teaneck, NJ 07666 U.S.A.

Please attach an original official bank statement

dated within the last six (6) months

or a letter of sponsorship to this form.