1
Declaration of Finances
(Confidential)
All undergraduate and graduate international applicants, both those applying from outside the United States and
those currently in the United States, must:
complete and send in this form
provide evidence of funding (in U.S. Dollars) to cover one year’s expenses*
provide a copy of your passport
These items are required after you receive your admissions decision from Nazareth College Admissions. They are
mandatory to enter Nazareth College. Sending them promptly ensures a successful visa application.
U.S. Citizenship and Immigration Services requires all students provide evidence of adequate funds to meet the
financial obligations of enrollment at a U.S. university. The combined U.S. dollar amount from your sponsor(s)
must equal or exceed the estimated expenses for one academic year minus any scholarships provided from
Nazareth College. (You’ll receive notice of any scholarship awards along with your application decision
notification). Bank verification of funds must not be older than one year.
Student’s Name ______________________________________
Permanent
Home Address _______________________________________
_______________________________________
_______________________________________
_______________________________________
Current Mailing _______________________________________
Address _______________________________________
_______________________________________
_______________________________________
City of Birth ________________________________________
Country of Birth _____________________________________
Term you will begin coursework: ___________________________
*Estimated Expenses - See naz.edu/costs
Fees and personal expenses may vary based on the anticipated needs of an average Nazareth student.
Choices in housing, meal plan, major, etc. may alter these amounts.
Students bringing dependents with them must show availability of an additional $6,000 per dependent
per year.
2
Student’s Sources of Funds (In U.S. Dollars)
Personal / Self Assured Support for First Year
$_____________________
Name of Bank ________________________________
Street Address ________________________________ Projected Support
Address (line 2) _______________________________ Second Year: $___________
City, State, Country ____________________________ Third Year: $___________
Phone Number ________________________________ Fourth Year: $___________
Family Sponsor Assured Support for First Year
Name of Person Sponsoring: _____________________ $_____________________
Relationship of student to Sponsor: _______________
____________________________________________ Projected Support
Name of Bank ________________________________ Second Year: $___________
Street Address ________________________________ Third Year: $___________
Address (line 2) _______________________________ Fourth Year: $___________
City, State, Country ___________________________
Phone Number ________________________________
Government Assured Support for First Year
$________________________
Name of Agency: _______________________________
Address of Agency_______________________________ Projected Support
Address (line 2) _________________________________ Second Year: $___________
City, State, Country _____________________________ Third Year: $___________
Phone Number _________________________________ Fourth Year: $___________
Other Assured Support for First Year
Name of Person Sponsoring: _____________________ $_____________________
Relationship of student to Sponsor: _______________
____________________________________________ Projected Support
Name of Bank ________________________________ Second Year: $___________
Street Address ________________________________ Third Year: $___________
Address (line 2) _______________________________ Fourth Year: $___________
City, State, Country ____________________________
Phone Number ________________________________
3
This is to certify that I have read the information furnished on this form, that it is a true and accurate statement,
and that the funds are available and will be provided as indicated.
___________________________________ ________________
Signature of Student Date
___________________________________ ________________
Signature of Parent, Guardian or Sponsor Date
In lieu of signing this document, sponsor not residing with student must submit a separate letter/affidavit
of financial support addressed to Nazareth College Admissions.
Send this paperwork with a copy of your passport to:
Nazareth College Admissions
Attn: International Admissions Counselor
4245 East Avenue
Rochester, NY 14618
USA
Fax: (585) 389-2826
Or email to: admissions@naz.edu
___________________________________________________________________________________________
For office use only:
This is to certify that I have reviewed the Declaration of Finances, and approve issuance of Certificate of
Eligibility.
_____________________________________ ____________________________
Signature of Nazareth College official Date
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