International Student Declaration of Finances Form - Pacific ...

International Student
Declaration of Finances Form
PLU MBA
2013-2014
General Information
The United States Citizenship and Immigration Services requires that Pacific Lutheran
University verifies the financial resources of all international student applicants. This form is for
that purpose.
Please note that the estimated costs listed below are for one academic semester only. You are
required to certify that you will have funds available for the costs listed. The estimated costs do
not include transportation costs to and from the United States. The estimated costs do not
represent the program if longer than one semester. The estimated costs do not include
dependents. You must prove an additional $5,000.00 per dependent.
Student visa holders are not authorized to work off campus in the United States except under
special circumstances. You should not plan on providing support for your education through
employment while a student.
For the PLU Office of Admission to issue an I-20 form, international graduate students
must:
Make the $300 non-refundable advance tuition deposit
Fill out the Declaration of Finance Form and provide supporting documentation
Provide a copy of their passport picture page
Provide the address to which the I-20 should be mailed (no PO Boxes)
Provide phone number associated with the address, to assist the courier service
Academic Year 2013-2014 Estimated costs MBA Program
Tuition and Living Expenses
Tuition for 18 semester credits (two terms) $ 20,340.00
Estimated Room and Meals $ 9,828.00
Estimated Miscellaneous (books, insurance, etc.) $ 4,418.00
Subtotal All Tuition and Living Expenses: $34,586.00
Scholarships/Tuition Waivers
International Student Grant $4,000.00
Subtotal All Scholarships: $4,000.00
Total Estimated Tuition and Living Expenses, less Scholarships:
$30,586.00 US

International Student
Declaration of Finances Form
PLU MBA
2013-2014
Statement of Financial Responsibility
To be completed by parent, family member, guarantor, or applicant even if support is personal
funds.
My relationship to this student is:______________________________________.
I hereby certify that I am willing and able to provide the amount of $30,586.00 US for the 2013-
2014 Fall semester payable in U.S. dollars towards the educational expenses of the applicant
named below.
Documentation of my financial resources accompanies this affidavit of support in the form of:
Please check one:
Official letter/s from bank/s including a current balance of the account. The
letter/s should be dated no earlier than twelve months before the term
applicant intends to enroll at PLU.
Copy of award letter from government or sponsoring agency
Name of Sponsor (please print):______________________________________________
Signature of Sponsor: ________________________________Date:_________________
Address of Sponsor: ______________________________________________________
Applicant must sign the statement below:
I hereby certify that all statements made on this declaration of finances are true and correct.
Name of Applicant (please print):____________________________________________
Signature of Applicant: ________________________________Date:________________
Return this page to the PLU Office of Admission by mail, email, or fax.
Mail: PLU Office of Admission, Graduate Programs
12180 Park Avenue South Tacoma, WA 98447-0003 U.S.A.
Email: gradadmission@plu.edu
Fax: Attn: Graduate Programs (253) 536-5136
For questions, you may contact:
Rachel Christopherson, Director of Graduate Admission,
Email: gradadmission@plu.edu | Phone: 253-535-7151