Severe Economic Hardship Request Form (Page 4 of 5) in pdf

Severe Economic Hardship Request Form Page 4

WRITE A BUSINESS LETTER

On a separate sheet; please explain your Severe Economic Hardship circumstances in the form of

a business letter. You need to include your F1 immigration history and who were your original

financial sponsors. Then, you need to describe how your financial support changed and how you

are faced with severe unforeseen financial problems.

Also, please include an itemized chart of all your personal expenses with current available

financial sponsorship, if any.

Use this as an EXAMPLE: Itemized chart for my annual expenses at BMCC

TUITION AND FEES

$3,165.70

BOOKS AND SUPPLIES

900.00

TRAVEL TO & FROM SCHOOL

480.00

HOUSING AND UTILITIES

9,000.00

FOOD

700.00

CLOTHING & PERSONAL NECESITIES

754.30

TOTAL

15,000.00

Current Financial Sponsorship

(‐‐‐‐)

(Subtract from TOTAL)

______________

Difference is what I am trying to obtain off campus work permission (=) __________

***PROOF OF ATTEMPT TO FIND EMPLOYMENT ONCAMPUS***

I CERTIFIED THAT I HAVE SOUGHT EMPLOYMENT AT THE BOROUGH OF MANHATTAN COMMUNITY

COLLEGE CAMPUS. THIS OPPORTUNITY IS EITHER NOT AVAILABLE OR INSUFFICIENT AS MY

DESIGNATED SCHOOL OFFICIAL HAS CERTIFIED IN MAKING THE RECOMMENDATION FOR

HARDSHIP EMPLOYMENT ON MY FORM I20ID.

***STATEMENT REGARDING MY GOOD ACADEMIC STANDING***

I AM IN GOOD ACADEMIC STANDING AND MY PERFORMANCE DEMONSTRATES THAT PART‐TIME

EMPLOYMENT LESS THAN 20 HOURS PER WEEK WILL NOT INTERFERE WITH MY CONTINUING TO

CARRY A FULL COURSE OF STUDY AND GETTING GOOD GRADES.

I swear that all of the information I have provided is true and correct.

Signature: ______________________________________

Date: __________________________

G:INTERNATIONALISSO FORMS - INFORMATIONAL DOCS - REPORTS 04-25-02ISSO FORMS - INFORMATIONAL

DOCS - REPORTS 04-25-02ISSO SEVERE ECONOMIC HARDSHIP EMPLOYMENT FORM 03-12-12.doc

Severe Economic Hardship Request Form Page 4