1

2015-16 The University of Georgia UGA Certificate of Finances for F-1 visas Terrell Hall & Athens, Georgia Supplemental Education Form 30602-1633 USA

The University of Georgia requires a statement of finances from students requiring an F-1 visa for their studies. This may include, but is not limited to those students who are not citizens of the United States or in the process of becoming legal permanent residents.

*An F-2 student wishing to study full time must change to the F-1 visa* This certificate, and the required supporting bank statements or documents, must be on file before an I-20 can be issued. Please complete the financial statement on page 3 of this application and attach original or certified and current bank statement(s). In order to be considered for admission, please include these materials by the deadline for the Application for Admission. If your source of financial support is from personal or family funds, you must attach an original or certified and current bank statement(s). If the cost of your education is being assumed by a sponsor, they must provide an original or certified and current bank statement(s) showing the availability of funds. Also include a photocopy of the first page of your passport. Two original sets of the supporting financial documents should be obtained. One set should be attached to the form and will become part of your permanent file. The other set should be used to present to the U.S. Embassy or Consulate. Neither photocopies nor faxes are acceptable forms of verification. All financial information must be dated less than one year prior to the first day of classes of the term in which you intend to begin your studies. The Supplemental Education Form on page 4 is required to provide the Office of Undergraduate Admissions a more accurate picture of your educational background before you applied to the University of Georgia. Part I. Applicant Information – PLEASE PRINT NAME AS IT APPEARS IN PASSPORT Applicant's Family Name:________________________________ First Name: __________________________ Foreign Mailing Address (please include Zipcode) :______________________________________________________________ ___________________________________________________________________________ United States Mailing Address (if applicable): ____________________________________________________ ____________________________________________________ Date of Birth: __ / / ____ month day year

Country of Birth: _________________________________ Country of Citizenship: ____________________________ Expected Visa Type: Foreign Student (F) Exchange/Visitor Visa (J)

None needed (attach explanation and documentation)

PLEASE RETURN COMPLETED FORM TO: Office of Undergraduate Admissions

Terrell Hall The University of Georgia Athens, GA 30602-1633

USA

2

Part II. Dependent Information Will a spouse and/or children be included on your visa? Yes No If yes, please provide the following information for each: full name, country of birth, date of birth, and relationship to you (ex: wife, husband, son or daughter). Also consult the Cost of Dependents table on this page for the additional costs to be included in the financial statement you provide. Name Date of Birth Country of Birth Relationship (Family name, Given name) (Month/Day/Year) (Wife, Son etc.)

What is the present exchange rate of your currency to the U.S. dollar (ex: 4 francs = $1)? Does your government currently impose restrictions on the exchange or release of its currency for study in the United States? Yes No If yes, describe the restrictions: Do you plan to remain in the U.S. during the summer? Yes No

If yes, do you plan to attend summer school? Yes No *** If yes, please refer to the 12-month costs provided.

If you will begin your enrollment at UGA during summer semester, you are required to submit financial documentation based on the costs for 12 months.

Costs for 9 Months

Costs for 12 Months

Costs for Dependents (add to total costs)

Tuition and fees $29,832.00 Living Expenses $11,432.00 Other $2,157.00 TOTAL $43,421.00

Tuition and fees $36,642.00 Room/Board/Misc $12,463.00 Books/Insurance $3,012.00 TOTAL $52,117.00

Spouse add $4,200 Child add $3,400 Spouse + 1 child add $6,800 each additional child add $1,300

Please note that costs are for the 2015-16 academic year.

Add 10% to the cost of attendance for each subsequent year. Tuition and Fees: Includes matriculation and student fees for full-time enrollment. Living Expenses: Estimate for a student living in a campus residence hall with a full, 7-day meal plan. Off- campus costs vary, but are generally higher. Books: Average cost for textbooks and supplies (notebooks, etc.). Additional expenses may arise for students requiring laboratory equipment, art materials, etc. Insurance: Health insurance is required of all international students prior to course registration. For assistance, contact the Office of International Education at http://uga.edu/oie/ISSIS/ or phone: 001-706-425-3154 fax: 001-706-583-0106.

PLEASE RETURN COMPLETED FORM TO: Office of Undergraduate Admissions

Terrell Hall The University of Georgia Athens, GA 30602-1633

USA

3

Please check the category or categories below that describes who will be financing your education and fill in the blanks. Also be sure to attach original or certified and current bank statement(s) to this form: I will be self-supporting I will be sponsored by a family member(s) I will be sponsored by another individual(s) Funds from University of Georgia I, _______________________________________, certify that I have read and fully understand the above financial statement. (Sponsor or Sponsors) I further certify that I have financial resources to cover all expenses of ___________________________________________, while in the United States. An original bank statement reflecting a continuous balance sufficient to cover the cost of attending The University of Georgia in US currency is attached to this form or will be submitted soon. I understand that the inclusion of any false information concerning financial support will be considered grounds for the student’s dismissal from the University of Georgia. ______________________________ ______________________________ ______________________________ Signature of Student Signature of Sponsor Signature of Sponsor Relationship to Applicant_______________ Date___________ *US$ Amount provided by Student for the First Year: $___________________ *US$ Amount provided by Family for the First Year: $_____________________ *US$ Amount provided by the University or Sponsor for the First Year: $___________________ *Note: Financial Information provided must be accurate and dated no less than one year prior to the date of enrollment. This is to certify that the information included on this form is complete and accurate to the best of my knowledge. I am fully aware that any false or misleading statements will result in automatic denial of my application for admission. _________________________________________________ ______________ Applicant’s Signature Date Return this form with SUPPORTING BANK STATEMENTS in a timely manner. An I-20 will not be issued without this completed form and an original or certified bank statement. (Faxed copies are unacceptable.)

All signatures and supporting documents must be either an original or a certified and current copy.

PART III. FINANCIAL SUPPORT

4

Supplemental Education Form

Please follow the instructions below in completing this form. It offers us a better idea of what your educational background has been before applying to the University of Georgia. Column 1 – On each line write the appropriate years for every school you attended. Column 2 – Write your correct age for each grade you attended. Column 3 – Write the kind of school your attended. Examples are Kindergarten, Gymnasium, Colegio, Lycee,

Grammar School, etc. Please indicate any intensive English Language programs in which you have been enrolled.

Column 4 – Enter the name of each school you attended. Column 5 – Write the city, village or town and country of the schools you have attended. Column 6 – Write the primary language used in class by your instructors. Column 7 – Write the name of any examination(s) passed or certificate(s) earned at the end of the school year. Please also attach any certified translations into English of these supporting documents.

Please complete this form and attach all supplemental materials to it.:

Office of Undergraduate Admissions Terrell Hall

The University of Georgia Athens, GA 30602-1633

USA

Calendar Year

AGE Kind of School (Elementary, Colegio, etc.)

Full Name of School

Address of School Language of Instruction

Certificates, Degrees, Etc.