Fillable Sfs Form Visiting (Hawaii Pacific University)

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Sfs Form Visiting (Hawaii Pacific University)

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STATEMENT OF FINANCIAL SPONSORSHIP (SFS) FORM
Valid for Academic Year: Fall 2020 – Spring 2021
VISITING STUDENTS
Requesting an I-20 from Hawaiʻi Pacific University
Part I: PERSONAL INFORMATION
Full Name (As it appears on your passport):
Last/Family Name:
First Name:
Middle Name:
Gender: Female Male
Date of Birth: (Month/Day/Year):
Country of Citizenship:
Country of Birth: City of Birth:
Email:
Contact Phone #:
Are you currently in the U.S.? Yes No
If "Yes", what visa classification do you hold?
If you are currently attending a school in the U.S., list the name of the school:
If you need to transfer your SEVIS record, please complete Transfer In Form that can be found at: http://www.hpu.edu/oiss/forms/index.html
PERMANENT (NON U.S.) ADDRESS:
(Address of your residence in your home country)
*ADDRESS YOU WOULD LIKE YOUR I-20 SENT TO:
(If you are currently in the U.S., you must pick up your I-20 at HPU OISS)
Address Line 1:
Addressee:
Address Line 2:
Required Contact Phone #:
(Must be a Non-U.S. #)
City:
Address Line 1:
Country:
Address Line 2:
Postal Code:
City:
Semester applied for:
Fall Spring
Country:
Applying as: Undergraduate Graduate
Postal Code:
Part: II: SOURCE OF FINANCIAL SUPPORT
All students must be able to demonstrate financial ability to pay for their academic and living expenses before Hawaiʻi Pacific
University can issue an immigration document. In addition, students must ensure that they have the funds available to cover all
expenses for the duration of their program of study.
Expense Breakdown
Undergraduate
Two-Semester
Graduate
One-Semester
Current Tuition and Fees
$29,520
$13,495
Room and Board
$19,260
$9,630
Other Expenses: Books, Supplies, Miscellaneous
$5,440
$2,720
TOTAL EXPENSES THAT MUST BE DOCUMENTED
$54,220
$25,845
1) The amounts indicated above are estimates All fees are estimated cost for immigration purposes only.
2) Exact tuition and additional fees may vary. For the most up-to-date figures and program-specific fees, visit: https://www.hpu.edu/business-
office/fee-schedule.html
**This is a two-page form. Be sure to complete both pages.
All items below must be submitted to OISS:
Passport
SFS Form
Financial Documents
Office of International Students Scholars (OISS)
Email: i20@hpu.edu
*Please be aware that your I-20 will only be sent to this address.
*I-20 can only be sent directly to the student (no agents, program coordinators, etc.)
REQUIRED DOCUMENTATION:
For each source of funding, you must attach financial documents in English and indicate in the amount in U.S. dollars on bank
letterhead, with a bank official’s signature, bank stamp or seal, and dated six months prior to the semester start date.
SOURCES OF FUNDS: Complete all that apply.
PERSONAL SAVINGS (Funds from self and private loans):
$
FAMILY/RELATIVE/INDIVIDUAL SPONSOR (Funds from family, extended family members, or other
individuals who are not legally present in the U.S.)
*Please print and sign (electronic signatures will not be accepted for this section)
Name of Sponsor: Relationship to Student:
*Individual Sponsor’s Signature: __________________________ Date: ______
$
GOVERNMENT/EMPLOYER/OTHER ORGANIZATION (Attach a signed copy of official sponsorship letter.)
Name:
Type: U.S. Government Company International Organization Home Government Employer
$
HAWAIʻI PACIFIC UNIVERSITY
(Funds from Scholarship, Merit Award, or other. Attach a signed copy of award letter)
$
TOTAL (Must be equal to or greater than the estimated expenses for one year in your program of study and
those related to supporting dependents if any. Total must match financial documentation.)
$
I certify that the above information and the attached supporting documents are true and complete to
the best of my knowledge. I understand that I am responsible for all the expenses related to my
program of study at Hawaiʻi Pacific University. *Please print and sign (electronic signatures will not
be accepted for this section)
Student’s Signature: ________________________________________ Date: _________
IMPORTANT NOTICE: Please be aware that HPU OISS will not accept this form if it is not
completely/accurately filled out in its entirety.
OISS 500 Ala Moana Blvd. Suite WP 5A Honolulu, HI 96813 P: 808.356.5299 i20@hpu.eduwww.hpu.edu/OISS Revised 2/18/2020
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Sfs Form Visiting (Hawaii Pacific University)

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Completed 23 July 2020

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