Belmont Abbey College
100 Belmont-Mt. Holly Road
Belmont, NC 28012
704.461.6665 / Statement of Financial Responsibility
THIS IS AN ELECTRONIC FORM. PLEASE FILL IT OUT, SAVE IT & EMAIL IT IN WITH THE REST OF YOUR INFORMATION.
Applicant Name: Click here to enter text. Click here to enter text. Click here to enter text.
Last/Family First/Given Middle
☐Male ☐Female Date of Birth Click here to enter text.
Month/Day/Year
U.S Department of Homeland Security regulations require the College maintain records showing you have met its financial requirements. You are required to certify adequate financial support to meet all educational and personal expenses for the duration of your studies at Belmont Abbey College. Complete support for your first year must be guaranteed. Form I-20 for the issuance of a visa cannot be processed until you have fully completed this statement of financial responsibility and returned it to the Office of Admissions. You are advised to keep copies of all financial documents submitted.
Financial Certification
This form must be accompanied by three months of bank statements from the responsible party’s bank showing the amount of money guaranteed. Without the appropriate supporting documents, your application will not be considered complete, and you will not receive the immigration form I-20. If you are sponsored by a private or government agency, provide an official copy of your award. Please note that official proof of funding cannot be more than 90 days old at the time of application and funding must be to be in liquid assets only.
Financial Responsibility
Sources and Amount of Financial Support in U.S. Dollars:
The approximate cost of the current academic year at Belmont Abbey College is $29,000*.
This includes tuition, fees, room, meals, books, and health insurance only. All travel and other personal expenses are not included.
Amount per year / Number of years of support Provided support providedFrom family or Self …………………………………………………….
(Complete the Affidavit of Support and submit supporting documents for each sponsor.) / $ Click here to enter text. / Click here to enter text.
Financial aid from government agency, private foundations,
bank, or other agency…………………………………………… ……..
(Enclose the original form or official copy of your award.) / $ Click here to enter text. / Click here to enter text.
Academic/Athletic Scholarship Award from Belmont Abbey College
(Enclose a copy of the award letter) / $ Click here to enter text. / Click here to enter text.
Total support for first year at Belmont Abbey College………………
(This amount must be at least $29,000*) / $ Click here to enter text. / Click here to enter text.
By signing this form, I certify that all the information is true, correct, and complete. I understand that I am responsible for all tuition, fees, and expenses incurred during the duration of my studies at Belmont Abbey College. With the exception of any scholarship offered to me by the College, I understand that Belmont Abbey College will not guarantee me on-campus employment, and I do not expect the College to assist my financially.
Click here to enter text. Click here to enter text.
Signature of Applicant Month/Day/Year
* Based on 2013-2014 costs, subject to change
Revised 11/30/2012
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