|
KALAMAZOO VALLEY COMMUNITY
COLLEGE
INTERNATIONAL STUDENT
CERTIFICATION AND DECLARATION OF FINANCES
_________________________________________________________________________
NAME OF APPLICANT (as it appears on
official documents)
__________________________________________
_________________________________________
Family name/Surname/Last
name
First name
_________________________________________________________________________
STATEMENT OF FINANCIAL SUPPORT
(To Be Completed by Your Financial Sponsor)
SPONSOR'S NAME
______________________________________
________________________________
Family name/Surname/Last
name
First name
RELATIONSHIP TO THE APPLICANT
_______________________
MAILING ADDRESS
__________________________________________________________________________________
Number
Street
_______________________
________________ _______________ ____________
City
State/Province
Zip/Postal Code Country
__________________________
_______________________
______________________________
Phone
Number
Fax
Number
E-Mail Address
HOW MANY INDIVIDUALS ARE DEPENDANT ON YOU FOR
SUPPORT? ________
HOW MANY DEPENDANTS ARE IN COLLEGE? _______
HOW MANY DEPENDANTS ARE IN SCHOOL? _________
EMPLOYED BY
______________________________________________________
TITLE
_________________________________________________
ANNUAL INCOME IN U.S. DOLLARS
$______________________
_________________________________________________________________________
Name of Bank
_________________________________________________________________________
Bank Account(s):
Savings Account Number _________________ $_______________________________
Balance in U.S. Currency
Checking Account Number ________________ $_______________________________
Balance in U.S. Currency
_________________________________________________________________________
I certify that I will support the
applicant named above while he/she is studying at Kalamazoo Valley Community
College in the amount of $___________________ each and every month. As
verification, I am providing the applicant with an official bank statement in
English, dated within the past six months, showing sufficient funds on deposit
and the U.S. currency equivalent. I have also provided evidence of my yearly
income as shown on one of the following documents: income tax returns or
receipts, an employment letter of verification, or an estimate from a bank or an
accountant.
____________________________________________________________
______________________
Signature of
Sponsor
Date
Revised July 1998
Admissions, Registration and
Records Office
|
