This form is designed to standardize nancial information provided by applicants to Whittier College. By completing and returning this form to the College, an
applicant, if admitted, may obtain the College’s authorization and issuance of a Certicate of Eligibility (Form I-20). Attach supporting documents. Individual
sponsors, such as parents or relatives, are required to sign the form and substantiate their ability to support the student by attaching an original ocial bank
statement or letter (in English) specifying the exact amount currently on deposit, or employer’s letter (in English) specifying the sponsor’s annual salary. All
letters must be specically addressed to Whittier College and must be dated within three months of the date of the student’s application to the University. A bank
ocial’s signature and bank seal are required on the certication if the student is partially or totally supported by personal savings. United States consuls
scrutinize the statements of nancial resources given by non-immigrant visa applicants. It is important that you answer each of the questions and obtain the appropriate
signatures, otherwise this form will be considered incomplete and your application will not be reviewed for admission to the College. A completed Financial
Certication will help United States consuls make their decisions and expedite the visa issuance.
Your Name :
Mr.
Ms.
Miss
Mrs. Birthday:
____________________________________________________________________________________________ ____________________
Complete the section below. Enter the expected amount of annual support from the following
sources. Enter amounts in US dollars. Please PRINT all entries.
Assured Support
Projected Support
First Year Second Year Third Year Fourth Year
A Certicate of Eligibility (Form 1-20)
will not be authorized until this form is completed and returned to the institution to which you are applying.
Both the form and certicate must be shown to the U.S. Consul to obtain a visa. I certify that the information on this form is true, correct, and complete.
I understand that any misrepresentation may be cause for refusing or revoking admission.
Signature of Student ______________________________________________________________ Date ______________________________________________
Ocial Certication of Sources of Funds and Amounts
This is to certify that I have read the information furnished
by the applicant on this form, that it is a true and accurate
statement, and that the funds are available and will be
provided as indicated.
________________________________________________
S
IGNATURE OF BANK OFFICIAL
Title ____________________________________________
Name of Bank ____________________________________
Address of Bank __________________________________
Date ____________________________________________
Parent’s signature is required (see certication
statement above.)
________________________________________________
S
IGNATURE OF PARENT
Address ________________________________________
Date ____________________________________________
Sponsor’s signature is required (see certication
statement above.)
________________________________________________
S
IGNATURE OF SPONSOR
Address ________________________________________
Relationship of Sponsor
to Student ______________________________________
Date ____________________________________________
What is the present exchange rate of your country’s
currency to the US dollar (for example, 10 pesos = $1)?
____________________________________________ =$1
Does your government currently impose restrictions on
exchange and release of funds for student in the U.S.?
Yes
No If yes, describe restrictions.
________________________________________________
________________________________________________
How will you pay for your transportation to the U.S.?
________________________________________________
$ $ $ $
Student’s Source of Funds
Personal or Family Savings
______________________
N
AME OF BANK
A bank ocial’s signature is
required on the certication
if the student is partially or
totally supported by
personal savings.
Parents
Money available from
sources other than savings.
______________________
F
ATHER ’S NAME
______________________
MOTHER ’S NAME
Please describe the source:
______________________
Sponsors
Money available from
sources other than parents.
______________________
S
PONSOR ’S NAME
______________________
SPONSOR ’S NAME
Please describe the source:
______________________
Your Government/Other
______________________
N
AME OF AGENCY
Enclose with this form a
signed copy of your letter of
award.
Total
MM/DD/YYYY
STUDENT’S NAME ________________________________________________________
Last Name First Name
