Alone With Spouse With Children
Part 1
Do you expect to come to the U.S.:
Dependents (if applicable):
Family (Last) Name Given (First) Name Date of Birth (mm/dd/yyyy)
City/Country of Birth
Relationship
Family (Last) Name Given (First) Name Date of Birth (mm/dd/yyyy)
City/Country of Birth
Relationship
If you are currently outside the U.S., what type of visa do you wish to receive? F-1 J-1
If you are currently in the U.S., what type of visa do you hold?
If you are currently in the U.S. on an F-1 or J-1 visa, which school, college, university or institute issued your I-20 or DS-2019?
Name and address of institution
GRADUATE FINANCIAL AFFIDAVIT
AFFIDAVIT: PAGE 1 OF 2
TUITION ESTIMATED
$29,575
$28,001
$28,001
$28,001
$24,139
$23,956
$27,431
$34,333
GRADUATE PROGRAMS - EDINA CAMPUS
MBA/MACC
PSM-GIS
PSM-ENG-MGMT
PSM-INFO-SECURITY
MPA
OTHER GRADUATE PROGRAMS
Ed.D./Psy.D.
DNP
(Based upon full-time status = enrolled in 9 credits per semester.)
TUITION ESTIMATED
$27,041
$27,041
$27,694
$22,995
$24,006
$24,006
$26,471
$33,372
GRADUATE PROGRAMS - MANKATO CAMPUS
MBA/MACC
PSM-GIS/PSM-ENG-MGMT
PSM-INFO-SECURITY
OTHER GRADUATE PROGRAMS
MSW
GRADUATE TEACHER LICENSURE PROGRAMS
Ed.D./Psy.D.
DNP
Dependent expenses:
$6,500 for the first dependent
$4,000 for each additional dependent
TUITION AND ESTIMATED LIVING EXPENSES FOR 9 MONTHS
Financial proof must be provided to comply with U.S. government regulations. Your Financial Affidavit must orginate from your source of support.
Submit this document and supporting financial proof with your application and other admissions documents. Final admission is not granted until
University Admissions is satisfied that all documents are complete and correct. The amounts listed are for the 2019-2020 academic year.
Applicant's Name:
(As it appears on Passport) Last/Family Name First/Given Name Middle Name
Tech ID Date of Birth (MM/DD/YYYY) City & Country of birth Country of Citizenship
I certify with my signature that the total amount of money that I have for my first year of study at Minnesota State Mankato meets the
minimum required for my program (including funds for spouse and children, when applicable) and I can cover the expenses of my entire program.
I certify the information provided is correct and complete and that I shall notify Minnesota State Mankato of any change in my financial
circumstances. I understand that inaccurate information can be cause for terminating enrollment at Minnesota State Mankato.
Student signature Date
Phone 507-389-1822 | Toll-free 800-722-0544
gradapp@mnsu.edu
http://mankato.mnsu.edu/future-students/apply/
Family (Last) Name Given (First) Name Date of Birth (mm/dd/yyyy)
City/Country of Birth
Relationship
click to sign
signature
click to edit
Part 2
DECLARATION OF FINANCIAL SUPPORT
SOURCE OF FUNDS AMOUNT ASSURED 1ST YEAR REQUIRED DOCUMENTATION
Student’s personal funds: U.S. $ Copy of bank statement
Family support: U.S. $ Sponsor’s certification and copy of bank statement
Name and relationship of family member(s):
Other support: U.S. $ Sponsor’s certification and copy of bank statement
Name and relationship of sponsor(s):
University support: U.S. $ Copy of award letter
Type of award:
Government/agency support: U.S. $ Copy of letter or document from government/agency
Name of organization:
TOTAL SUPPORT U.S. $
is amount should add up to the tuition and estimated living expenses on page 1 of the Affidavit.
CERTIFICATION OF AGREEMENT BY STUDENT
APPLICANT: Please provide the REQUIRED signature and date below. By signing here, you are agreeing to the following statement.
I certify that the information provided is correct and complete and that I shall notify Minnesota State University, Mankato of any changes in my financial
circumstances. I understand that inaccurate information can be cause for terminating enrollment at Minnesota State University, Mankato.
Student signature Date
CERTIFICATION OF AGREEMENT BY SPONSOR
, am able and willing to provide financial support to
per year while she/he studies at Minnesota State University, Mankato.
Date
I certify that I,
for the total amount of U.S. $
Sponsor’s signature
Sponsor’s address
Tel
Fax
Name of student
AFFIDAVIT: PAGE 2 OF 2
UPDATED: 4/20
A member of the Minnesota State system and an Affirmative Action/Equal Opportunity University.
This document is available in alternative format to individuals with disabilities by calling the College of Graduate
Studies and Research at 507-389-2321 (V), 800-627-3529 or 711 (MRS/TTY).
click to sign
signature
click to edit
click to sign
signature
click to edit
Chrome Web Store
It looks like you haven't installed the Fill Chrome Extension Add to Chrome