Fillable Printable Affidavit of Support - La Roche College
Fillable Printable Affidavit of Support - La Roche College
Affidavit of Support - La Roche College
4848.GLOBALE.9/13.GK
Section 1 • ApplicAnt informAtion
• Name of Applicant
LAst/surNAme First/GiveN middLe
• Country of Citizenship date of Birth - -
mm dd yyyy
i certify that the information provided on this Adavit of support Form is correct and complete.
• signature date - -
mm dd yyyy
Section 2 • SponSor informAtion
Each sponsor should ll out only one of the following parts. Evidence of available funds must be in the form of original notarized or certied
ocial bank statements, employers’ guarantees/statements or agency nancial guarantee.
Part 1 – Privately Supported Students
Please complete this part if you are parent, guardian, relative or friend of the applicant whose name appears above. Please note that
the applicant may choose to change his intended program of study at any time.
As a nancial sponsor, i attest to my ability to provide full nancial support for all expenses of the above applicant’s study at
La roche College. i am providing evidence of available funds for at least one academic year of the program indicated on his/her
application to the College.
• Name of sponsor
LAst/surNAme First/GiveN middLe
• relationship to Applicant
• signature date - -
mm dd yyyy
Part 2 – Company/agency Supported Students
Please complete this section if you are authorized to submit nancial statements on behalf of your company, organization,
government or other agency. Please note that the applicant may choose to change his intended program of study at any time.
i certify that as a nancial sponsor of the applicant whose name appears above, the company/agency will named below nancially
support the applicant’s study at La roche College. the company/agency is providing evidence of available funds for at least one
academic year of the program indicated on his/her application to the College.
• Name of Company/Agency
• Name and title of Authorizing Ocial
• signature of Authorizing Ocial date - -
mm dd yyyy
1
adavit of Support | Financial resources Form
International Undergraduate admissions
finAnciAl reSourceS AvAilAble: SummAry StAtement
institutional compliance with u.s. law and immigration regulations require that all international applicants provide
evidence of sucient nancial resources to support their education. the total of estimated funds available to you
from all sources (whether single or combined) must at least meet the total of estimated academic year costs for
your degree program at La roche College. Funds available must be indicated in u.s. dollars.
PerSonal FUndS avaIlable (Part 1)
Country Currency $
Bank Certication: q enclosed q Will be sent
Other Financial Certication/documentation: q enclosed q Will be sent
agenCy FUndS avaIlable (Part 2)
Country Currency $
Bank Certication: q enclosed q Will be sent
Other Financial Certication/documentation: q enclosed q Will be sent
total (1 and/or 2)
Country Currency $
• NOte: Limited nancial assistance is available to qualied international students.
• i certify that the information provided on the Adavit of support Form is correct and complete.
• signature date - -
mm dd yyyy
adavit of Support | Financial resources Form
International Undergraduate admissions
2
la roChe College
9000 Babcock Boulevard
Pittsburgh, PA 15237-5898
usA
phonE: 412-536-1279
Fax: 412-536-1188
Email: international@laroche.edu
wEb: laroche.edu
