International Student Verification
of Financial Support
2 01905-042
This form is to be completed by all international students who have been accepted to study at Northern Essex Community College (NECC)
and who require a student visa (F-1). This form is not an application for admission, but is required to declare your nancial resources during
your stay. The Form I-20, which is used to obtain your F-1 student visa, cannot be issued without submission of this form.
In addition to completing this form, the applicant’s nancial sponsor, parent, or guardian, must provide an ocial letter from a
bank in English certifying that the sponsor has sucient funds, in U.S. dollars, to pay for at least one year of study at NECC.
Estimated Costs Per Academic Year Attending NECC (2 semesters – 12 credits per semester) is $24,570*.
• Tuition and Fees - $11,972 • Books - $1,400
• Health Insurance - $2,390 • Living Expenses - $8,808
Estimate for Dependents:
• Spouse - $4,404
• Child - $2,202
* Rates will change for 2020-2021 academic year when set by the Board of Trustees. The updated rates will be reected on the bill.
This form must be completed by the student and his/her nancial sponsor and returned to the International Student Oce.
PART I: Student Information
Name ______________________________________________________________________________________
Last First
I certify that all information submitted regarding my nancial support is complete and accurate to the best of my knowledge.
Furthermore, I agree to assume all nancial responsibilities should my source(s) of funding be interrupted or stopped.
Student ’s Signature _____________________________________________________ Date ________________________________________
Part II: Sponsor Information
Name ______________________________________________________________________________________________
Last First
Address_ ____________________________________________________________________________________________________________
Ci t y/ St ate / Pr ov i nce __________________________________ P os t al Co d e_________________ C o u n tr y _______________________________
P h o n e_________________________________ Relationship to Applicant_______________________________________________________
I agree to pay the cost of attendance at Northern Essex Community College for the student listed above. I certify that all
information provided for verication of nancial support is complete and accurate.
Sponsor’s Signature _____________________________________________________ Date ________________________________________
International Student Oce | 100 Elliott Street | Haverhill, MA 01830 | Phone: 978-556-3726
Fax: 978-738-7450 | Email: international@necc.mass.edu
2019-2020 Academic Year
click to sign
signature
click to edit
![]()
click to sign
signature
click to edit
![]()
