Financial Affidavit for F-1 Student Visas
All students in the U.S. on an F-1 Visa must show proof of financial support for each year of study. To meet this requirement, you
must submit the following to the ITT Technical Institute to show that you have sufficient funds for study.
• A financial affidavit (this form) signed by you and all of your financial sponsors; and
• A bank statement or other comparable evidence of financial stability.
Please note the following:
• Submit only original documents. Do not submit photocopies or faxes.
• Submit this form and all supporting documents together in one envelope.
• Bank statements must be less than one year old at the time of application.
• Bank and/or sponsorship letters must be on the official letterhead of the organization.
• You will probably need additional original documents when applying for a visa at a United States consulate.
• ITT Tech will not issue a Form I-20 until you are admitted and have returned a signed Enrollment Agreement.
Submit all international admissions documents to the attention of the DSO or Registrar at the ITT Technical Institute for which
you wish to make application. Select one of the following:
3401 S. University Ave. 7955 N.W. 12 St. Ste. 119 630 E. Brier Drive, Ste. 150
Ft. Lauderdale, FL 33328 Miami, FL 33126 San Bernardino, CA 92408
9680 Granite Ridge Drive 7300 Boston Blvd. 2295 Millersport Highway
San Diego, CA 92123 Springfield, VA 22153 (DC) Getzville, NY 14068 (Buffalo)
2950 S. Gessner 12720 Gateway Dr., Ste. 100
Houston, TX 77063 (W. campus) Seattle, WA 98168
A. Student Information
Last Name:_____________________________________First Name: ____________________________________
Email: ___________________________________ Permanent Phone: ____________________________________
Permanent Address:_________________________________________________ ___________________________
Current Address___________________________________________: Current Phone:________________________
Program of Interest:_____________________________________________________________________________
ITT Tech (address):______________________________________________________________________________
Expected Start Term: Fall / Winter / Spring / Summer Expected Enrollment Year: _________________________
Date of Birth: ___________ Town and Country of Birth:________________ Country of Citizenship: _____________
Are you in the United States now? YES NO If YES, specify non-immigrant status held: ___________________
Marital Status: Single Married
__I plan to come alone __I plan to have my dependents come later __I plan to bring the following dependents with me.
Dependent 1 Dependent 2 Dependent 3 Dependent 4
Relationship to Student
Date of Birth
Country of Birth
Last Revised: April 7, 2004
B. Financial Support Verification
1) Personal Savings
Print bank name: ______________________________________ Amount: US $ ___________________________
2) Parents and/or Sponsor
This is to certify that I am willing and able to support and maintain the above named student for the amount indicated
for every year of his/her enrollment at the ITT Technical Institute.
Print Name: __________________________________________ Amount: US $ ___________________________
3) Government Agency
Print agency name: _____________________________________Amount US $ ___________________________
Note: Enclose a signed copy of letter or award with this form.
4) Company Sponsor
Print company name:____________________________________Amount US $ ___________________________
Print name of company designee: ____________________________ Signature: ___________________________
Note: Enclose a signed affidavit from authorized person to certify accuracy of sponsor. (Use additional sheet if necessary.)
Applicant must not look to full-time or part-time employment as a means of support while attending ITT Technical Institute.
Does the country from which your funds come restrict exchange and release of funds for study in the United States?
If YES, what are the restrictions and how will they affect your payment of expenses? ________________________
C. Estimated Expenses for One Year
The following financial estimate is based on the current tuition and shared living arrangements. It does not include
airfare, owning/operating an automobile, or travel within the United States. Living Expenses can vary widely based on
the location of the ITT Technical Institute. Tuition expenses are subject to change without prior notice.
Tuition & Fees $17,700.00
Housing, Food, Utilities, Transportation $9,000.00
Medical Insurance (mandatory) Varies on situation
Total (US Dollars) $26,700.00 + insurance
I, _______________________________certify that the total amount of money that I have available for my academic
study at ITT Technical Institute is at least US $26,700 per year of undergraduate study.
STUDENT’S SIGNATURE:____________________________________________ DATE: _____________________
Last Revised: April 7, 2004