Certification Of Financial Support

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CERTIFICATION OF FINANCIAL SUPPORT
Enter the expected amount of annual support from the sources listed below. Enter amounts in US dollars. Please PRINT all entries. Use an additional sheet of paper
for explanations, if necessary. You must provide evidence of financial support equal to a minimum of 60% of Bethany's annual fees.
la. OFFICIAL CERTIFICATION OF SOURCES OF
Assured support
Estimated support
FUNDS AND AMOUNTS
1. STUDENT'S SOURCES OF FUNDS
This is to certify that I have read the information furnished by the
applicant on this form, that is a true and accurate statement, and that the
YEAR 1
YEAR 2
YEAR 3
YEAR 4
funds are available and will be provided as indicated.
1a. PERSONAL
FAMILY SAVINGS
OR
Signature of Bank Official
Title
Name of Bank
Name of Bank
A bank official's signature is required on the
Address of Bank
certification if the student is partially or
totally supported by personal savings
Date
1b. PARENTS
1b. Parent's signature is required (see certification statement above)
Signature of Parent
Father's Name
Address
Mother's Name
Please describe the source:
Date
1c. SPONSORS
1c. Sponsor's signature is required (see certification statement above)
Money available from sources other than parents:
Signature of Sponsor
Address
Sponsor's Name
Sponsor's Name
Relationship of
Please describe the source:
Sponsor of Student
Date
1d. YOUR GOVERNMENT
4. How will you pay for your transportation to the US?
5. What is the total amount of money you expect to have when you
Name of Agency
arrive at this institution? US$
Enclose with this form a signed
6. Do you plan to remain in the US during the summer?
Yes
No
copy of your letter of award.
7. If remaining in the US, do you plan to attend summer school?
Yes
No
TOTAL:
$
$
$
$
8. What are the sources and amounts of support available to
you during the summer?
2. Does your government currently impose restrictions on exchange and release
of funds for study in the US?
Sources:
US$
Yes
No
If yes, describe restrictions
US$
Yes
No
US$
3. Do you have a source for emergency funds once you arrive in the
US?
US$
If yes, name source
Amount available in US dollars $
I VERIFY THAT THE INFORMATION WRITTEN ON THIS APPLICATION IS TRUE AND COMPLETE.
Applicant's Signature:
Date:
Admission Office
Bethany, West Virginia 26032
U.S.A.
website:
Telephone (304) 829-7611
FAX (304) 829-7142
E-mail: admission@mail.bethanywv.edu
Produced with
The Princeton Review

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