c:\users\caharris\desktop\form b-financial certificate.doc
OFFICIAL CERTIFICATION OF SOURCES OF FUNDS AND AMOUNTS
This is to certify that I have read the information furnished by the applicant on this form, that it is true and accurate, and that the funds
are available and will be provided as specified. (Attach current bank statement.)
Bank Official’s Signature and Seal:
Bank Official’s Name (Printed):
This is to certify that I have read the information by the applicant on this form, that it is true and accurate, and that the funds are
available and will be provided as specified. (Attach current bank statement.)
Parent/Sponsor Name: (Printed):
Relationship to Applicant:
12. I, ____________________________, (applicant’s name) certify that the total amount of money that I have available for my first
academic year of study at Fayetteville Technical Community College is $ __________, and that the total amount available for each
subsequent year of study is $ ____________. I also certify that I will buy adequate health hospitalization insurance. I further certify that
the above information provided is correct and complete and that I shall not require additional financial assistance.
13. I am applying for entry into the following curriculum: __________________________________________________
14. Describe your significant work experiences (responsibilities, positions held, type of business, ministry, teaching, etc.).
15. Describe your career objectives. What do you plan to do with your education?
Applicant’s Signature: ___________________________________________ Date: ______________________