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Office of Admissions International Application FINANCIAL RESOURCES STATEMENT (For International Students only) Name: ____________________________________________________________________________________ Family First/Given Middle SECTION A - FAMILY INFORMATION (DEPENDENT STUDENT) If you are dependent upon your parents or other family member(s) for daily living expenses, fill in this section completely. (If you do not depend on someone else, skip this section and go to Section B.) Father’s Name: ______________________________________ Occupation: ___________________________ Mother’s Name: ______________________________________ Occupation: ___________________________ Give the following information for those that are dependent on you parents: Name Age Relationship ________________________________________ ________ _______________________ ________________________________________ ________ _______________________ ________________________________________ ________ _______________________ ________________________________________ ________ _______________________ ________________________________________ ________ _______________________ SECTION B – FAMILY INFORMATION (INDEPENDENT STUDENT) If you are not dependent upon your parents, or are married and have your own family to support, fill in this section completely. Give the following information for each person who is financially dependent on you: Name Age Relationship ________________________________________ ________ _______________________ ________________________________________ ________ _______________________ ________________________________________ ________ _______________________ ________________________________________ ________ _______________________ ________________________________________ ________ _______________________ Which of those listed will come with you to the U.S.? __________________________________________________________________________________________ __________________________________________________________________________________________ Of those who remain at home, who will continue to dependent upon you while you are in the U.S.? __________________________________________________________________________________________ __________________________________________________________________________________________ How will their expenses be covered? __________________________________________________________________________________________ Will you need to provide money to them while you are in the U.S.? ____________________________________ How much? US$ __________________ per month US$ ___________________ per year SECTION C – FINANCIAL INFORMATION Give present value of family assets (your parents if you are dependent, yours if you are independent) Home………………. US$ __________________ Savings …………. US$ _________________ Land/Buildings…….. US$ __________________ Investments …….. US$ _________________ Checking Account … US$ __________________ Other …………… US$ _________________ Sources of income: 2006 Estimated 2007 Yourself ………………………. US$ _________________________ US$ __________________________ Parents …………………………US$ _________________________ US$ __________________________ Spouse (if married) …………… US$ _________________________ US$ __________________________ Other …………………………. US$ _________________________ US$ __________________________ Do you have a source for emergency funds once you arrive in the U.S.? Explain. __________________________________________________________________________________________ __________________________________________________________________________________________ How will you pay for transportation to the U.S.? __________________________________________________________________________________________ SECTION D – SPONSOR/SUPPORT INFORMATION List agencies/foundations/government to which you are or will be applying for aid/sponsorship: Source Date Decision Expected ___________________________________________________________ ________________________ ___________________________________________________________ ________________________ ___________________________________________________________ ________________________ ___________________________________________________________ ________________________ Source Amounts: Family………………. US$ __________________ Student Savings …………. US$ _________________ Relatives ……...…….. US$ __________________ Government ……… …….. US$ _________________ Friends …………... … US$ __________________ Agencies …… …………… US$ _________________ I/We declare that the information on this form is true, correct, and complete. Providence Christian College has my/our permission to verify the information reported. ___________________________________________________________ ________________________ Signature of Student Date ___________________________________________________________ ________________________ Signature of parent, sponsor, or guardian (if dependent student) Date 2 SPONSORSHIP Name: ____________________________________________________________________________________ Family First/Given Middle It is the student’s responsibility to be sure that all funds are sent in a timely manner so bills are paid by the required due date. DOCUMENTATION FOR SAVINGS/INVESTMENTS: An official signed statement or letter from the bank confirming the value of your/your parent’s savings (convert all amounts to U.S. dollars) DOCUMENTATION FOR SPONSOR(S): A current signed and notarized letter from each sponsor stating intent to cover expenses with an exact U.S. dollar amount STUDENT’S AND/OR PARENTS’ SAVINGS/INVESTMENTS AVAILABLE FOR EDUCATION Name & Address of Bank(s): __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ PERSONAL SPONSOR (RELATIVE, FRIEND, OR EMPLOYER) Name of Sponsor: ________________________________Relationship: ______________Amount: US$ ______ Name of Sponsor: ________________________________Relationship: ______________Amount: US$ ______ AGENCY SPONSOR (GOVERNMENT, ORGANIZATION) Name of Agency Sponsor: ______________________________________________ Contact Person: __________________________________________ Amount: US$ ______ E-mail: ________________________ Address of Agency Sponsor: __________________________________________________________________ ADDITIONAL SPONSORS 1. Name of sponsor: ___________________________________________________ Amount: US$ ______ Address: __________________________________________________________ E-mail: _________________ 2. Name of sponsor: ___________________________________________________ Amount: US$ ______ Address: __________________________________________________________ E-mail: _________________ 3. Name of sponsor: ___________________________________________________ Amount: US$ ______ Address: __________________________________________________________ E-mail: _________________ 3