CERTIFICATE OF FINANCIAL RESPONSIBILITY

For Non - U.S. Citizens Only

The U.S. Immigration and Naturalization Service requires educational institutions to obtain evidence that all applicants have adequate

funds to pay for their educational and living expenses while studying in the United States.

Understanding that tuition, fees, room and board, and other costs usually increase 4 - 6% from the previous year, fill out the financial

certificate below. Fill in the amount guaranteed and attach the required documents to this form. A certificate of eligibility (I-20) will not

be issued until this form and the required documentation is complete.

Student’s Name: ___________ Country: ________ _______________________

Source of Support Documentation Required Amount Guaranteed

your first year of study. Statement of financial responsibility

(below) signed by parent or sponsor.

$

___________________

Please include a notorized affidavit of support OR an I-134 sponsorship document.

Name of parent or sponsor:

Relationship to student:

Address:

Fax:

This is to certify that I will be responsible for all expenses of the above named student during his or her studies at Wisconsin Lutheran

$

per year

for

 Loan

Copy of your loan agreement prepared by the lending

institution.

$

per year

for

I certify that the amount of funds available to me (excluding travel funds) for my first academic year at Wisconsin Lutheran College is

U.S. $