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STATEMENT OF FINANCIAL SUPPORT
Section A: To be completed by the applicant.
Name ________________________________________________ Country of Citizenship ________________________________
Address ______________________________________________ Intended Enrollment Date __________ ___________________
______________________________________________
It is necessary that students from abroad have sufficient finances to meet all expenses while attending Iowa Central Community College.
Expenses such as tuition, room, board, books, spending money, etc., would necessitate as a minimum the cost per calendar year of
$11,500.00 in U.S. currency. If you plan to travel in the U.S., it will necessitate additional money.
1. Will the currency exchange regulations of your government show the release of a sufficient amount of funds to you in
United States Dollars? _____ yes _____ no
2. Indicate in the following table the sources and amounts of money in United States dollars that you expect to have available each
year to meet necessary expenses after you arrive in the United States.
3. Attach an original bank statement to support the amounts listed.
Sources of Funds Amount Years of Study in the United States
First Year Second Year Third Year
20___-20___ 20___-20___ 20___-20___
Personal Savings $__________ $__________ $__________ $__________
Parental Support $__________ $__________ $__________ $__________
Other Sources (please specify)
________________________ $__________ $__________ $__________ $__________
________________________ $__________ $__________ $__________ $__________
________________________ $__________ $__________ $__________ $__________
Total per Calendar Year $__________ $__________ $__________
4. I hereby certify that I have read and understand the information on expenses provided by Iowa Central Community College and
that the information I have given on this form is complete and accurate to the best of my knowledge.
Signature_________________________________________________ Date_____________________
Section B: To be completed by the sponsor(s) of the applicant.
If more than one sponsor is aiding the applicant, the following certification must be copied, signed by each sponsor and the additional
certification(s) attached to this form.
This is to certify that I have read the information describing current costs of attendance given to the applicant, that I have carefully read the
form and entries made by the applicant on the form, and to further certify that I am (or my agency of firm is) prepared to provide funds to pay
the applicant’s expenses for the period of time and to that extent indicated above. I am mailing this form directly to the Admissions Office,
Iowa Central Community College, 330 Avenue M, Fort Dodge, IA 50501.
Signature _______________________________________________________ Date _______________________________
Name (please print)_________________________________________ Relationship to Applicant _____________________________
Name of Sponsoring Organization (if any) _________________________________________________________________________
Address ___________________________________________ Occupation ________________________________________
___________________________________________ Employer _________________________________________
