Certification of Finances

This information will be kept confidential. Please print, complete, sign, and send the original copy of this form directly to:

Office of International Admissions
Mary Baldwin College
Staunton, VA  24401
USA
1.Your Name [ ] Mrs. [ ] Miss______________________________________
2. Your Permanent Address__________________________________________
_______________________________________________________________
3. Mailing Address (if different from your permanent address)
_______________________________________________________________
_______________________________________________________________
4. Telephone Number_________________________________
5. Your Country of Birth____________________________
6. Date of Birth ____________________________
7. Country of Citizenship_______________________
 
8. Student's Source of Funds (Please PRINT all entries and attach extra paper if needed.)
How many years do you plan to study at Mary Baldwin College?________
 
Student's Source of Funds  Assured Support
(Academic Year)
First Year
Sept. 20______
Second Year
Sept. 20____
Third Year
Sept. 20___
Fourth Year
Sept. 20___
 a. Personal or Family Savings $ $ $ $
 b. Parents $ $ $ $
 c. Sponsors $ $ $ $
 d. Your Government $ $ $ $
 TOTAL Please enter amounts in U.S.$ $ $ $ $
 
a. Personal or Family Savings
Name of Bank ____________________________________
Address of Bank__________________________________
_______________________________________________
 
This is to certify that I have read the information furnished by the applicant on this form and it is a true and accurate statement. The funds are available and will be provided as indicated. * A bank official must sign the Certification of Finances if the student is partially or totally supported by personal savings.
 
* Signature of Bank Official __________________________________________________
Title:______________________________________________ Date:____________
 
b. Parents
Money available from sources other than savings.
 
Name:____________________________________________
Explain Source______________________________________
 
This is to certify that I have read the information furnished by the applicant on this form and it is a true and accurate statement. The funds are available and will be provided as indicated. ** Parent's signature is required.
 
** Parent's Signatures_______________________________________________________
Address____________________________________________ Date:_______________
 
c. Sponsors
Money available from sources other than parents.
 
Name______________________________________________
Name______________________________________________
Explain Sources______________________________________
__________________________________________________
 
This is to certify that I have read the information furnished by the applicant on this form and it is a true and accurate statement. The funds are available and will be provided as indicated. *** Sponsor's signature is required if applicable.
 
***Sponsor's Signature______________________________________________________
Address_____________________________________________ Phone_______________
Relationship to student__________________________________ Date________________
 
d. Your Government
Money available from your government.
 
Name of Agency:______________________________________
Send us a signed copy of your letter of award.
 
In addition to charges for tuition, room and meals at Mary Baldwin College, there will be other costs you must pay. Refer to "Current Charges" for the current cost of attending Mary Baldwin College. You are responsible for all academic costs. Do you have the funds required?
  ___ Yes   ___ No
 
Transportation to and from the United States must be paid by the student. Do you have funding for this international transportation cost in addition to the funding you listed under "Student's Sources of Funds?"   ___ Yes   ___ No
 
Do you have an additional source for emergency funds once you arrive in the U.S.?
  ___ Yes   ___ No
If yes, please give the name of the source:_______________________________________
 
School is in session for a nine-month academic year, from September through May. Summer vacation extends from June through August. Do you plan to remain in the United States during the summer?
  ___Yes   ___No
If yes, do you plan to attend summer school at another college or university?   ___ Yes   ___ No
 
What is the source and amount of support available to you during the summer:
Source:_______________________________________ Amount: US$_____________
 
What is the present exchange rate of your country's currency to the U.S. dollar?
(For example: 20 pesos=$1)________________________ =$1
 
Does your government currently impose restrictions on exchange and release of funds for
study in the U.S.?   ___ Yes   ___ No
If yes, describe restrictions.
_____________________________________________________________________
_____________________________________________________________________
 
 
Certification of Eligibility (I-20) will not be authorized until you complete this form and return it to Mary Baldwin College. You must show the I-20 to the U.S. Consul to obtain a visa.
 
This is to certify that this statement is made by me to insure the United States government that I, the student applicant, will not need assistance from any local, regional, or federal government agency while I am a student in the United States. I am ready and willing to deposit a bond, if necessary, to guarantee that I will not become a public charge during my stay in the United States. I certify that the information on this form is true, correct, and complete. I understand that any misrepresentation may cause Mary Baldwin College to refuse or revoke my admission to the College.
 
Signature of Student_______________________________________ Date___________
 

Please PRINT the above form and send the completed form to:
International Student Admissions
Mary Baldwin College
PO Box 1500
Staunton, VA 24402
USA

For more information e-mail admit@mbc.edu