Wayne County Community College District Statement Of Financial Support
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1
2Wayne County Community College District
(PLEASE PRINT OR TYPE)
– ANSWER ALL ITEMS –
INTERNATIONAL STUDENT
STATEMENT OF FINANCIAL SUPPORT
Sponsor’s Name__________________________________________________________________________________________________________
Sponsor’s Address ________________________________________________________________________________________________________
1. I, (sponsor’s name) _____________________________________________________, being duly sworn, affirm and say:
(A) that I am a citizen of (country) ____________________________________________________________________________________
(B) that I will provide full financial support for (student’s name)___________________________________________________________
(C) that I am employed as, or engaged in the business of _________________________________________________________________
with (name of company) ___________________________ at (address) ___________________________________________________
and have a net annual income of U.S. $ ____________________. (Attach letter from employer or other verification of income.)
(D) that I have ____________________ persons dependent on me for support.
(E) I further certify that all statements above are true and I understand that an admission based upon this statement will be valid as
long as the statement is valid.
You must sign the Statement of Financial Support in your full, true and correct name and affirm it or make it under oath.
Sponsor’s signature _______________________________________________________________________________________________________
Subscribed and sworn to before me this _____________ day of _______________ 20____ at _____________________________________
_______________________________________________________________
_________________________
Signature of Officer
(Stamp or Seal)
DECLARATION AND CERTIFICATION OF FINANCES
A Certificate of Eligibility (Form 1-20) cannot be authorized until this section is completed to our satisfaction to show that adequate
funds are guaranteed for your educational needs.
Assured Amounts in U.S. $
First
Second
Source of Funds
Official Verification of
Year
Year
Sources of Funds and Amounts
Parents and/or sponsors (please print name(s)):
This is to certify that I have read the information
_______________________________________________
$
$
furnished by the applicant of this form, that it is a
Personal savings (please print name of bank):
true and accurate statement, and that the funds are
_______________________________________________
$
$
available and will be provided as indicated.
(A bank official’s signature is required below.)
Sponsor’s signature __________________________________
Your government (please print name of agency):
_______________________________________________
$
$
Date __________________________________________________
(Enclose a signed copy of your letter of award.)
Sponsor’s name ______________________________________
Other (please specify):
Relationship of sponsor to applicant:
_______________________________________________
$
$
________________________________________________________
Address________________________________________________
Totals:
$
$
________________________________________________________
Enter the total amount of money you expect
This is to certify that I have read the information
to have when you arrive at WCCCD:
U.S. $
furnished by the applicant on this form, that it is
true and accurate, and that funds are available.
I, __________________________________________, certify that the total amount of
money (exclusive of travel) available to me my first year (12 months) is $ ______________
Bank official’s signature ______________________________
in U.S. money, and that the total amount available for each subsequent year is $ ________
Bank official’s name __________________________________
in U.S. money. Further, I certify that the above information provided is true and complete
Date __________________________________________________
and that I shall notify Wayne County Community College District of any change in my
Name of bank ________________________________________
financial circumstances.
Bank’s address ________________________________________
Student’s signature ________________________________Date __________________
________________________________________________________
Portions of this Certificate have been adapted from the original Declaration of Certification of Finances
of the CSS of the College Entrance Examination Board.
Return completed form to: Admission Office, Wayne County Community College District, 801 W. Fort, Detroit, MI 48226
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