Fillable form you will need in order to apply (Monmouth College)

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INTERNATIONAL STUDENT FINANCIAL
CERTIFICATION FORM
Monmouth College is pleased to offer financial assistance to qualified international students based on academic
ability.
Available funds must be certified (documented with copies of bank statements and loan award letters) before we can issue the I-20
form you will need in order to apply for your student visa.
All supporting documents must be in English and dated within one year of initial enrollment at Monmouth College.
Please include all required official documentation listed in the certification section (including copy of family bank statements).
Instructions for the International Student Financial Certification Form
Please read the following instructions carefully before completing the International Student Financial Certification Form and submitting
evidence of funding.
U.S. Immigration and Naturalization Service regulations require institutions to obtain evidence that applications have adequate financial
resources for their expenses while studying in the U.S. Funds may come from a variety of sources including scholarships, fellowships,
sponsoring agencies, continuance of salary, the applicant’s family, or any dependable source. The completion of the International Student
Financial Certification Form, along with supporting evidence of funding, are required parts of the International Student Application.
All international applicants, both those applying from outside the United States and those currently in the United States, must submit the
International Student Financial Certification Form and provide evidence of funding.
STUDENT INFORMATION (Please print carefully and legibly.)
Student Name:
Family
First, Personal, or Use Name
Middle Name or Patronymic
Permanent Home Address
(Please print as it would
appear on a postal envelope
and on the I-20 form. A P.O.
Box is not acceptable.):
Telephone Number
E-Mail Address
City & Country of Current Residence
Birthdate (mm/dd/yyyy)
Citizenship
Country of Birth
FUNDING CERTIFICATION SECTION
Costs for the 2018-2019 Academic Year
$37,674
$ 8,966
$ 1,
600
TOTAL: $48,240 TOTAL:
One-Time Orientation Fee ($195) & Enrollment Deposit ($200) (for the first year of college only): $ 395
Please answer the following questions:
1. Exchange rate of your country’s currency to the U.S. Dollar (e.g.: 1.42 lev or 13.33 pesos = $1): _____ = $1
2. In what currency (currencies) do you and your family receive income? _____________________________
3. Will there be any circumstances besides your study in the United States (such as a sibling also entering college) in the next five
years that will cause a significant increase or decrease in the family’s expected level of support? Yes No If yes,
please attached a separate page to explain.
4. Summer residence
A. Will you reside in the U.S. during the summer? Yes No
B. If so, who will support you?
Source__________________________
Amount US $__________________
Source__________________________
Amount US $__________________
Source__________________________
Amount US $__________________
Definition of Terms
Personal Funds Student’s own savings or draft/checking account funds. An original letter on bank stationery indicating sufficient funds is
required. Date the account(s) opened, name of the account holder, and present balance are required.
Family Funds Student’s family savings or draft/checking account funds. Real estate holdings, personal property, and common stock
holdings should NOT be used to confirm financial support. An original letter on bank stationery indicating sufficient funds is required. Date
the account(s) opened, name(s) of account holder, and present balance are required.
Private Sponsor (family member other than parent or family friend) Private sponsor’s savings or draft/checking account funds. Real
estate holdings, personal property, and common stock holdings should NOT be used to confirm financial support. An original letter on bank
stationery indicating sufficient funds is required. Date the account(s) opened, name(s) of account holder, and present balance are required.
Government or Agency Sponsor An original, official letter of Billing Authorization is required. Full disclosure of the extent and amount of
government agency support is necessary. Inclusive dates of sponsorship or special conditions are required.
Foreign Government Loans Authorized/approved loan guarantee forms or letters are required. Inclusive dates of authorization and
distribution of funds are required.
College Support Monmouth College support - awarded merit scholarship amount
PERSONAL SAVINGS
Guaranteed Support
Please list amount of financial support available for the
appropriate year in United States dollars.
First Year
$________________
Estimated Future Support
Second Year
$________________
Third Year
$________________
Fourth Year
$________________
Name of Bank
Address of Bank
Title of Bank Official
E-Mail Address of Bank Official
Telephone Number for Bank Official
PARENT CONTRIBUTION
Guaranteed Support
Please list amount of financial support available for the
appropriate year in United States dollars.
First Year
$________________
Estimated Future Support
Second Year
$________________
Third Year
$________________
Fourth Year
$________________
Name
Address
Signature (required)
Name of Bank
Number of Years Employed by this Company or
Organization
$________________
Address of Bank
Annual Salary
Place of Employment
Website Address of Place of Employment
Address of the Place of Employment
Telephone Number of Place of Employment (immediate
supervisor, business partner, direct report, or CEO)
SPONSORS (for sources other than savings)
Guaranteed Support
Please list amount of financial support available for the
appropriate year in United States dollars.
First Year
$________________
Estimated Future Support
Second Year
$________________
Third Year
$________________
Fourth Year
$________________
Name
Address
Signature (required)
Relationship to Student
Name of Bank
Address of Bank
GOVERNMENT SUPPORT
Guaranteed Support
Please list amount of financial support available for the
appropriate year in United States dollars.
First Year
$________________
Estimated Future Support
Second Year
$________________
Third Year
$________________
Fourth Year
$________________
Name of Agency
Address of Agency
Contact Person
Enclose an official copy of your letter of award.
TOTAL CONTRIBUTION TO TUITION AND FEES
In providing documentation for available funds with a bank statement or loan letter, the more funding you can show that you have truly
available for your first year of study, the better prepared you will be for a successful visa interview.
Your total amount of funding for Year One shown in your bank statement should include the amount you need to cover non-college costs
(books, travel, and personal expenses).
* If you are a transfer student, please complete the values only for the years you will be spending at Monmouth College.
First Year = $____________ Second Year = $____________ Third Year = $___________ Fourth Year = $____________
Sample Bank Statement (to accompany current bank statement)
On Bank Stationery
To Monmouth College:
This is to certify that [name of sponsor] holds an account with our bank. The amount of funds available in this account is [amount
in the applicant’s country’s currency], equivalent to [amount in U.S. dollars]. This account has been in effect since [date].
[Signature of Bank Official] [Date]
Bank Seal or Stamp
Sample Letter from Sponsor’s Employer (to accompany current bank statement)
On Employer’s Stationery
To Monmouth College:
This is to certify that [name of sponsor] has been employed at [name of company] since [month and year]. His/Her salary is
[amount per month or year].
[Signature of Employer] [Date]
If you will be supported by your government or sponsoring agency, attach an official copy of your sponsorship award letter. If you will be
supported by private funds, the sponsor should complete the affidavit of support (available at
http://www.monmouthcollege.edu/admissions/international/sponsor-affidavit-of-support.aspx) and have his/her bank supply a dated bank
statement or a certified letter stating that sufficient funds are available to cover tuition and living expenses while studying in the U.S.
I certify that, to the best of my knowledge, the information provided on this form is true and accurate. I shall notify Monmouth College of
any changes in my financial circumstances. I understand that providing false information may be justification for revoking my acceptance
or termination of enrollment as a student.
Signature of Student
Date (mm/dd/yyyy)
Name of Parent (Please print carefully and legibly.)
Signature of Parent
Date (mm/dd/yyyy)
Please send all documents to:
Monmouth College ● Office of International Admissions ● 700 East Broadway ● Monmouth, IL 61462 ● USA
Telephone: + 1.309.457.2131 ● Email: international@monmouthcollege.edu ● Web site: www.monmouthcollege.edu
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Completed 23 August 2020

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