450UNIVFM16
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Personal Information (exactly as it appears in your passport)
Family Name First Name Middle Name
Date of Birth (month/day/year) Place of Birth: City Country
Country of Citizenship (If you have dual citizenship, please list the country of the passport you will use to enter the U.S.)
Gender Male Female Other
IMMIGRATION AND FINANCIAL DECLARATION FORM
Mailing Address in your Home Country
Street Apt. No. City
Province/Territory Postal Code Country
Phone # Email
Mailing Address in the US (if you are currently in the US)
Street Apt. No. City
State Postal Code
Phone # Email
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Date (month/day/year)
Immigration Information
1. Are you presently in the United States on an F-1 Visa? Yes No
If Yes, please complete this Transfer-in Form and give it to your current International Student Advisor to return to Lesley University as soon as possible.
If Yes, do you plan to travel outside the U.S.A. before attending Lesley University?
Yes No
Leaving U.S. (month/day/year) Returning to U.S. (month/day/year)
2. Will you require an I-20 to obtain your F-1 visa / study in the U.S.? Yes No
If No, what status do you/will you have?
Please list all American schools you previously attended and the dates you were at these schools:
School Name Start Date End Date Degree Sought
School Name Start Date End Date Degree Sought
School Name Start Date End Date Degree Sought
Application for an I-20
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Financial Information
For your I-20, we must see proof that you have enough assets for tuition and living expenses for one full year. You can find that information in your
Estimate of Expenses, which was included in your email welcome packet. If you can’t locate it, please email iss@lesley.edu for another copy.
For your proof of finances, you must submit the following:
Family information
Will you be living in the United States with a spouse or child? Yes No
If YES, complete the following:
1. Will your spouse or child/children need a visa through your immigration status?
Yes No
2. Will your children need a visa through your immigration status?
Yes No
3. Please list all family members who will need a visa while they live with you while you are in the U.S.:
First Name Family Name Date of Birth Place of Birth Citizenship Relationship to You
First Name Family Name Date of Birth Place of Birth Citizenship Relationship to You
05/25/2016
To International Student Services:
I, Jane Smith, will support my daughter, Jill Smith for her tuition and living expenses while she studies at Lesley University.
Please find attached my bank documents showing my ability to pay.
SIGNATURE
Student Signature
Date (month/day/year)
SCAN AND EMAIL
Please send this form and all documents to iss@lesley.edu
QUESTIONS?
Email iss@lesley.edu for assistance
A letter from your bank showing the current account balance
» The letter must be in English
» The letter must be less than 6 months old
» If possible, it should show the account balance in both the
local currency and USD
If the bank account is not in your name, you must have your sponsor write
you a brief typed-and-signed letter indicating that they are sponsoring
your for your tuition and living expenses. See below for an example.
If you are being sponsored by your government or another organization,
you must submit a letter, on letterhead, indicating the total amount of
your sponsorship and the dates of your sponsorship
You may have multiple bank accounts and multiple sponsors —
altogether, you must have at least the amount indicated on your
Estimate of Expenses.
Sample Sponsorship Letter
If you are showing any bank accounts which are not in your name, you must have your sponsor(s) write you a brief typed-and-signed letter. The letter should
include your name, your sponsor’s name, and your relationship to the sponsor. It should be typed, signed, and dated. Here is an example letter:
CHECKLIST
This completed Immigration and Financial Declaration Form.
Copy of the identity page and the expiration date
page of your passport.
Your current financial documents.
Your letter(s) of financial sponsorship.
Transfer form. (If you are transferring or have just graduated
from a U.S. university, you must have this form completed
and provided to the International Student Services Office
at Lesley University as soon as possible.
If you will have a dependent spouse/child,
please submit a copy of their passports.
click to sign
signature
click to edit