Yes
No
Not Applicable
*Additional $2,000 for one dependent, $3,000 for two dependents, $4,000 for three dependents
Student Full Name:
Student's E-mail address:
Source of Support:
Self
Family
Government/ Sponsoring Agency
Other
SPONSOR INFORMATION (if self-sponsored, leave this section blank)
Sponsor Name:
Sponsor's E-mail address:
Relationship to student:
Do you need an acceptance letter to secure funding from your government or sponsoring agency?
This affidavit is to assure the United States government that the student named above will not become a
public charge while in the United States. I, the sponsor, hereby affirm that I will make the following amount
available:
I have attached a bank statement to verify my capability to provide this amount.
YES NO
INTERNATIONAL STUDENT
AFFIDAVIT OF FINANCIAL SUPPORT
Sponsor's Signature:
Date:
INTERNATIONAL STUDENT
AFFIDAVIT OF FINANCIAL SUPPORT
Office of International Education and Services
One University Plaza MS2000 Cape Girardeau, MO 63701 - 573.986.6863 - international@semo.edu
