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UNIVERSITY OF HAWAI‘I HILO ▪ GRADUATE DIVISION
Graduate Division • 200 Kāwili St. • Hilo, HI 96720 Tel: (808) 932-7332, Fax: (808) 932-7338 • e-mail: hilograd@hawaii.edu • Web: hilo.hawaii.edu/academics/graduate
CONFIDENTIAL FINANCIAL STATEMENT FORM FOR INTERNATIONAL APPLICANTS
INSTRUCTIONS: Attach official bank statement(s) if your bank will not complete the BANK VERIFICATION section. If sponsored by a government or
private organization, a signed award letter is required. Bank statements may not be more than 90 days old. Mail-in completed form and
documentation to the address above, or submit by fax or e-mail attachment.
Estimated Student Budgets : All tuition and fee charges at the University of Hawai'i campuses are subject to change in accordance with State law and/or action
by the Board of Regents or university administration. (See Financial Aid for the Estimated Annual Student Budgets for Non-Resident Students for the academic
year you plan to enter. Please note that Health Insurance is also required so you must add an additional $2500 to your budget.)
Pacific Island Exemption: Futuna, Kiribati, Nauru, Niue, Solomon Islands, Tokelau, Tonga, Tuvalu,
Vanuatu, Wallis
nternational Students (Not Pacific Island Exemption)
Type or print clearly. Where not applicable, write "N/A"
Use names as listed on passport:
A. Family/Last Name
First Middle
Gender
Male
Female
Semester
Fall
Spring
Year
Current Telephone
State/
County
Postal
Code
Place of Birth
Country of Citizenship
MM/DD/YY
City and Country
Country of Legal
Permanent Residency
Name of
Employer
If employed by home government, indicate whether city, provincial or central government.
Country Issuing Passport
Occupation
Personal funds available for
first year of study (US$
)
I agree to be financially responsible for my expenses at the University of Hawai‘i Hilo for the duration of my study and I will notify the Graduate
Admissions Office of any change in my financial circumstances. Confirmation of the first year of support is provided as financial evidence. I certify
the information provided on this form is correct and complete to the best of my knowledge.
Date
Signature of Applicant
MM/DD/YY
BANK VERIFICATION This is to certify that the applicant listed above is financially capable of the monetary support
indicated above and if the funds are outside the U.S.A., there are no government restrictions regarding the release of the
funds. This certification is offered with no responsibility on the part of this bank or financial agency.
Name of
Type of
Date
Account
Account
Opened
Holder (MM/YY)
Name &
Address of Bank
Name of
Bank Official
Signature of
Title
Bank Official
Date
Bank Seal or Stamp
_____________________________________________________
e-mail address
Permanent Foreign Address
Street
City
Date of Birth
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