Certificate Of Financial Responsibility Form (Page 2 of 2) in pdf

The university is required to review your financial documentation prior to issuing an I-20 or DS-2019 form. You must document sufficient funds

available for your first year’s academic and living expenses and assured sources of support for subsequent years. You are responsible for all payments

to the university in accordance with the tuition/fee schedule in effect at the time of your enrollment for each semester of your attendance. The

amounts shown on this form and on your I-20 or DS-2019 are estimates only. Your academic costs may vary depending on your program of study,

the number of credits for which you enroll, and the date you commence study. Your living expenses may vary depending on your housing and lifestyle

choices. All costs are subject to change.

The estimated costs for the 2015–16 academic year (9 months)

Graduate

Undergraduate

(9 credits)

Tuition and Fees

$29,914

$26,170

Living Expenses

$15,987

$17,812

(room, board, transportation, and personal expenses)

Required Medical Insurance

$2,532

Estimated Total Costs

$48,433

$46,514

If you plan to live in the United States for the full year (12 months), please plan for 33 percent higher living expenses.

Students in F-1 and J-1 status are required to enroll full time during each fall and spring semester but are not required to enroll for summer. The tuition costs shown

are based on minimum enrollment for nine months (fall/spring) of study and do not include summer tuition. Living expenses are shown for 9 months.

Tuition figures listed are estimates and are subject to change. Tuition rates are set annually in late spring for the following academic year. Some programs, including

Government, Law, and Management, may charge tuition at a higher rate. We reserve the right to request additional documentation if necessary prior to issuing your I-20

form. The latest tuition rates, listed by program, can be found at studentaccounts.gmu.edu/tuition-fees.

NOTE: Tuition may vary for graduate students holding assistantships. Stipends and benefits are determined by each academic department. You may use your stipend as

partial proof of financial support. Please refer to your offer letter for award details and include a copy of the letter with this form.

Sources of Funding

You must document your sources of funding for the full term of your study at George Mason University. The funds for the first year must be guaranteed,

either currently on deposit or documented in a scholarship letter if you are a sponsored student. Funds for the subsequent years must be committed

by your sponsor or scholarship source. If you are relying solely on your own personal funds, you must show funding on deposit for the full term of

your study. Bank statements may include checking

Funding Source

Amount Per Year in U.S. Dollars

or savings accounts, certificates of deposit, or money

market accounts. We do not accept real property,

Personal funding



corporate assets, or salary letters. Send current

Funding from parent or individual sponsor



(within the previous 6 months) original bank state-

ments and/or letters of support, including the

Funding assistance from Mason



appropriate signatures of the issuing authority.

Government sponsor



If the source(s) of your support will change after

the first year, please explain on a separate sheet.

Private organization/employer



Your signature is required below. For each year

Other



of study, undergraduate students must show a total

of $48,433. Graduate students must show a total of

Total

$46,514. Please refer to the table above.

Please Note

• Students holding F-1 or J-1 visas should not anticipate employment as a means of support while at Mason. Employment for students with F-1 and

J-1 visas is restricted.

• The payment schedule is posted on studentaccounts.gmu.edu each semester.

Applicant: I certify that the information provided here is correct and complete. I will be responsible for adhering to all university tuition, fees, room

and board, and health insurance payment schedules.

________________________________________________________

_____________________________________________________

Signature of applicant

Date and place signed

Print name

Last (family name)

First

Parent/Sponsor: This is to certify that I have read the information provided by the applicant on this form; it is true, accurate, and complete; and

the funds are available and will be provided as stated.

________________________________________________________

_____________________________________________________