Declaration and Certification of Finances

DECLARATION AND CERTIFICATION OF FINANCESRequired for Non-American CitizensYou are required to certify how you plan to pay for your first academic year and how you will meet your expenses for additional years of study if you expectyour program to require more than one year. Students who plan to stay in the United States through the summer will need additional funds for food, housing,and summer school tuition. Students who hold a student (F-1) visa will not be authorized to work off-campus except in businesses approved by the U.S.Department of Labor. Limited part-time employment opportunities may be available on campus during the academic year and the summer. Do not expect toearn sufficient money from part-time work to provide significant support while you are at Wartburg College.Keep a copy of this document to help demonstrate to the United States Consular officials that you have sufficient funds.PLEASE ANSWER THE FOLLOWING QUESTIONS:1. How will you pay for your transportation to the United States? _________________________________________________________________________2. How will you pay for your return transportation? ___________________________________________________________________________________3. Please check appropriate box: ■ I plan to come alone.■ I plan to bring the following dependents(please list and specify their relationship to you):______________________________________________________________________________________________________________________________________________________________________________■ I plan to have my dependents come later.■ I expect my program of study to require:■ one year ■ two years ■ three years ■ four years.Wartburg College International Admissions Office222 Ninth St. N.W.P.O. Box 1003Waverly, Iowa 50677-0903U.S.A.E-mail: global-admissions@wartburg.eduTel: 001 319 352 8264Fax: 001 319 352 8579(THE REVERSE SIDE OF THIS APPLICATION MUST BE COMPLETED.)FEB. 2000

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 privatefunds, the guarantor must complete the affidavit of support below and have his/her bank supply a certified letter stating that sufficient funds are available tocover tuition and living expenses while the student is studying in the United States.STUDENT’S FINANCIAL PLANPLANNED SOURCE OF FUNDSREQUIRED DOCUMENTSFIRST YEAR(in U.S. dollars)ALL OTHER YEARS(in U.S. dollars)PERSONAL SAVINGSBank Statement$ _____________________$ _____________________FAMILY OR FRIENDBank Statement$ _____________________$ _____________________COMPANY/BUSINESSLetter$ _____________________$ _____________________GOVERNMENT AGENCYLetter$ _____________________$ _____________________WARTBURG COLLEGENone$ _____________________$ _____________________OTHERLetter/Statement$ _____________________$ _____________________TOTALS$ _____________________$ _____________________AFFIDAVIT OF SUPPORT to be completed by parent or sponsorI promise to pay $ ___________________________________________________________________________________________ in U.S. dollarsfor the educational expenses of ____________________________________________ who is _________________________________________.Name of StudentRelationship to StudentDocumentation of my financial ability is attached.___________________________________ _________________________________________________ ______________________Printed Name Signature Date_______________________________________________________________________________________________________________________Address________________________________________ ___________________________________ _______________________________E-mail Tel. No. Fax No.I, _______________________________________________________ , CERTIFY THAT THE TOTAL AMOUNT OF MONEY I HAVE AVAILABLE FORPlease Print NameMY FIRST ACADEMIC YEAR OF STUDY AT WARTBURG COLLEGE IS U.S. $ _________________ AND THAT THE TOTAL AMOUNT AVAILABLEFOR EACH SUBSEQUENT YEAR OF STUDY IS U.S. $ _______________.FURTHER, I CERTIFY THAT THE ABOVE INFORMATION IS CORRECT AND COMPLETE AND THAT I SHALL NOTIFY WARTBURG COLLEGE OFANY CHANGE IN MY FINANCIAL CIRCUMSTANCES OR ACADEMIC STATUS.STUDENT’S SIGNATURE ____________________________________________________________ DATE ________________________________Warning: I understand that providing false information may jeopardize a student’s visa status and result in expulsion from Wartburg College. Studentsmay be requested to prove their financial sources, in detail, by U.S. Embassy visa officials and Wartburg College officials.