Fillable International Student Financial Aid Application and Certification of

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International Student Financial Aid Application and Certification of

On average this form takes 40 minutes to complete

The International Student Financial Aid Application and Certification of form is 3 pages long and contains:

  • 3 signatures
  • 11 check-boxes
  • 141 other fields

Country of origin: OTHERS
File type: PDF

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STUDENT INFORMATION
Name Last/surnameFirst/given
Male
Female
E-mail addressDate of birth (mm/dd/yyyy)
Parents current marital status:
Married Separated Divorced Father deceased Mother deceased Other
Mother’s name LastFirst
Mother’s address
Mother’s occupation/ employer
How many people, including yourself, depend on the income of your parents for daily living expenses?
Father’s name
LastFirst
Father’s address
Father’s occupation/ employer
PARENT/FAMILY INFORMATION
1
Please complete this application and return it to Lake Erie College’s Office of Admission.
International Student Financial Aid
Application and Certification of Support
Name: Age:
Relationship
to you:
School Name:
Year
in School:
Tuition and
Total Costs:
Scholarships
and Gifts:
Amount
Parents Pay:
Please provide information for each family member you included in previous question. Please do not include information about yourself.
If married, how many people are nancially dependent on you?
Marital status:
Single Married Divorced
FINANCIAL INFORMATION
How will you pay for your transportation to the United States?
Do you have a source of emergency funds once you arrive in the U.S.?
Yes
No
If yes, name source:
Estimated amount available in the U.S.:
Last year,, how much of your household income (before taxes or expenses) came from the following sources?
Note: All values should be in U.S. dollars.
If Other, please explain:
Will there be signicant increase or decrease in your family’s income next year?
Yes
No
FAMILY ASSET INFORMATION
Please list the value of the following family assets (if applicable). Note: All values should be in U.S. dollars.
FAMILY EXPENSE INFORMATION
Please list the amount your family spent on the following expenses last year (specic amounts are needed).
Note: All values should be in U.S. dollars.
2
Father’s work:
Mother’s work:
Your work:
Your spouse’s work:
Family business:
Family real estate holdings:
Pension/ annunity/ retirement:
Other members of the household:
Interest or dividends:
Housing, food, and other living allowances:
Other:
$
$
$
$
$
$
$
$
$
$
$
If yes, please be specic:
Land and Buildings (other than home or business):
Savings:
Money in another country:
Assets in another country:
Assets owned by student:
Investments (stocks/ bonds):
Property in another country:
$
$
$
$
$
$
$
Rent or mortgage:
Food:
Medical expenses:
Loan payments:
Insurance (health and property):
Utilities:
Household necessities:
Education expenses for siblings:
Other:
$
$
$
$
$
$
$
$
$
If Other, please explain:
SPECIAL CIRCUMSTANCES
STUDENT’S EXPECTED SUPPORT FOR EDUCATIONAL EXPENSES
In the space below, enter the amount of annual support toward your educational expenses from the sources listed below.
Note: All values should be in U.S. dollars.
3
Please indicate in the provided space any unusual expenses, other debts, or special circumstances that the
institution may need to take into consideration:
1st year 2nd year 3rd year 4th year
Family’s income:
Family’s assets:
Student’s assets:
Relatives & friends:
Agencies & foundations:
Private Sponsors:
Your Government:
Other:
Note: please provide any necessary supporting documentation to verify income and asset information requested on this form, such as tax
forms, statement from employer, bank statements, letter from sponsors/ agencies, etc.
Explain external source funding (agencies, foundations, private sponsor, government, and/or other):
Lake Erie College | 391 West Washington Street | Painesville, Ohio 44077 | 1.855.GO.STORM | lec.edu
CERTIFICATION AND AUTHORIZATION
By submitting the Lake Erie College International Financial Aid Application and Certication of Support, we declare that the
information on this form is true, correct and complete.e College has our permission to verify the information reported by obtaining
documentation as needed.
Student’s Signature:
Parent’s/ Guardian’s Signature:
Parent’s/ Guardian’s Signature:
Date:
Date:
Date:
Warning: Providing false information may jeopardize a student’s visa status and furthermore may result in Lake Erie College revoking its initial decision to
enroll a student.
Note: Submitting the Lake Erie College International Financial Aid Application and Certication of Support does NOT guarantee that you will recieve
additional funding.
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Completed 26 January 2021

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