CERTIFICATION OF FINANCIAL SUPPORT FOR INTERNATIONAL STUDENT APPLICANTS
Providing sound proof of financial support is a required factor in admission and visa consideration. It must be evident that you can provide the funding necessary to study at Lebanon Valley College. In addition to completion of this form, you must submit either a certified bank statement or a retirement or savings statement totaling the amount of support available to you for your education at Lebanon Valley College. Send these documents with certified English translation if necessary to: Lebanon Valley College, Office of Admission 101 N. College Ave., Annville, PA 17003-1400 USA Please type or print clearly and fill in every section. N/A should be used for questions that are not applicable. APPLICANT INFORMATION SURNAME/FAMILY NAME
GIVEN NAME
MIDDLE
PERMANENT ADDRESS
CURRENT MAILING ADDRESS (IF DIFFERENT FROM ABOVE)
TELEPHONE
FAX
EMAIL
DATE OF BIRTH
COUNTRY OF BIRTH
MONTH
DAY
YEAR
COUNTRY OF CITIZENSHIP
FINANCIAL INFORMATION DOLLAR AMOUNT (IN U.S. DOLLARS)
I CERTIFY THAT THE INFORMATION ON THIS FORM IS CORRECT AND COMPLETE.
SOURCE
YEAR 1
SPONSOR NAME (PLEASE PRINT)
YEAR 2
SPONSOR SIGNATURE
YEAR 3
RELATION TO STUDENT
YEAR 4
STUDENT SIGNATURE
ASSURED SUPPORT DATE
PROJECTED SUPPORT
PROJECTED SUPPORT
PROJECTED SUPPORT MINIMUM PROOF OF SUPPORT FOR 2016–2017 IS $35,570.
101 North College Avenue | Annville, Pa. | 17003
[email protected] | www.lvc.edu
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