Affidavit of Sponsor Support

This form indicates who will support you financially while you study. IF you plan to support yourself, please complete this form with your name as the sponsor. If you have more than one sponsor, each sponsor should complete a separate form.

Name of Sponsor: ______

Birth Date ______Email Address: ______Phone Number ______

Street Address ______City ______

State/Province ______Postal Code ______Country ______

Occupation: ______Relation to Student: ______

The minimum amount of support required for EACH 4-month semester is US$5,295.

US$2,495 for Tuition

+ US$2,800 for Living Expenses

US$5,295 PER SEMESTER

An additional US$1500 per semester is required for each dependent who will accompany the student. All dependents must be listed below in the indicated portion.

DEPENDENTS: List name and relationship to student of all dependents (spouse and children) who plan to accompany the student to the US. (List additional on back.) Please include a photocopy of each dependent’s passport.

Name: ______Relation to Student: ______

I certify that I will provide financial support in the amount of $______per semester (4 months) for ______(name of student).

The sponsor must show a minimum of US $5635 (US $2995 for tuition plus US $2640) for living expenses) for each 4-month semester. The sponsor must show an additional US $1500 per semester for each dependent that will accompany the student.

Total amount from student ______Total amount from the sponsor: ______

Comments: ______

______

Sponsor Signature:______Date ______

Notary Public Signature: ______Date______

Authorizing stamp or seal:

This document must be accompanied by financial documents to verify that the required amount is available. Financial documents must be less than 60 days old. Acceptable financial documents include bank statements, income statements, or proof of income certified by an employer. A black and white photocopy of the passport of each person who will be coming to the U.S.A. must also be included.

Sponsor Financial Declaration

Fill out the information below as completely and thoroughly as possible. We want to be able to get a clear idea of your financial standing. If you have any financial obligations, incomes, savings or expenses that you were not able to report here, please turn this paper over and write on the back.

Financial Assets / Amount / Name of Bank or Institution / Address / Phone Number
Cash / $
Savings Account / $
Money Market / $
Invested / $
Other / $
Other / $
Total Assets / $ / N/A / N/A / N/A
Household Monthly Income * / Amount / Address / Phone Number
Primary Earner 1st Job / $
Primary Earner 2nd Job / $
Second Earner 1st Job / $
Second Earner 2nd Job / $
Other income / $
Total Income / $ / N/A / N/A

Adopted 10/2015III.6.e

Total Monthly Expenditures / $
Total Monthly Income Beyond Expenditures / $

______

Sponsor NameSponsor Signature Date

384 W. Center – Provo, Utah 84601 – Phone 801-377-3223 – Fax 801-377-3993 –