International Financial Certificate Form - Florida Institute of Technology

FINANCIAL CERTIFICATE FOR UNDERGRADUATE PROGRAM OF STUDY
This form must be completed and returned to the Undergraduate Admission Office.
Florida Institute of Technology ■ Office of Undergraduate Admission
FINANCIAL CERTIFICATE FOR
UNDERGRADUATE PROGRAM OF STUDY
All admitted international students who intend to enroll must certify that they have funds to cover their expenses while attending Florida Institute of Technology.
This includes students who have been awarded fellowships, scholarships or other university support. International students cannot be issued an I-20/DS-2019,
nor be enrolled, until this form has been completed and submitted in its entirety.
STUDENT INFORMATION
Last Name _________________________________________________ First Name _________________________________ Middle Name _____________________
Mailing Address ________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________________
City and Country of Birth _________________________________________________________________________________________________________________
Dependents:
o I plan to come alone
o I plan to have dependents join me later
o I plan to bring dependents with me:
o Spouse/adults _____________________________________
o Child/children (indicate the number of dependents: ____ )
ESTIMATE OF FLORIDA INSTITUTE OF TECHNOLOGY UNDERGRADUATE SCHOOL EXPENSES FOR 2012-13
Tuition and Fees Living Expenses Other Total
Aviation with Flight $48,000 $10,320 $2,400 $60,720
Aviation without Flight $33,000 $10,320 $2,400 $45,720
Engineering and Science $36,000 $10,320 $2,400 $48,720
Business and CoPLA $33,000 $10,320 $2,400 $45,720
A married student with dependents (spouse and/or children) will need an additional $5,000 for one dependent, $7,500 for two dependents, and $10,000 for three
or more dependents.
Please note: Living expense estimates are based on shared accommodations and reflect a very basic standard of living.
SOURCES OF SUPPORT FOR 2012–13
When you compute your support (below), bear in mind that federal regulations severely restrict employment eligibility for individuals in Student (F) and Exchange
Visitor (J) status. Therefore, you should not look to employment, either part-time during the academic year or full-time during the summer, as a significant means
of support while at Florida Institute of Technology. F-2 dependent spouses and children are not permitted to work under any circumstances. J-2 Exchange Visitor
dependents may apply for employment authorization from U.S. Citizenship & Immigration Services. Funds from J-2 employment may not, however, be used
to support the Exchange Visitor and his/her family. The request for work authorization must clearly document family finances/expenses and affirm that the J-2
dependent is seeking work permission for other reasons (i.e. professional development, money for travel, etc.).
150 West University Boulevard, Melbourne, FL 32901-6975 ■ (321) 674-8053 ■ Fax: (321) 728-4570
admission@fit.edu
SA-741-912
Page 1 of 2

Florida Institute of Technology ■ Office of Undergraduate Admission
FINANCIAL CERTIFICATE FOR
UNDERGRADUATE PROGRAM OF STUDY
Florida Institute of Technology Undergraduate School Financial Certificate for 2012–13
For adequate certification, the total amount below must equal the total costs based on the cost estimate on page 1 and adjusted for any accompanying
dependents. All documentation must be submitted in English and must be dated within the last six months. Indicate all amounts in U.S. Dollars.
SOURCE AMOUNT
1. Personal and/or family savings
Name of bank:_______________________________________________________________________________________
Note: Any amount entered must be verified both by a bank official’s signature below and by an enclosed original bank statement. $
2. Parents and/or sponsors
Name(s) of each sponsor(s):_____________________________________________________________________________
Note: Each sponsor must sign below and must provide a bank certification as below, along with an original current bank statement. $
3. Your government
Name of agency:______________________________________________________________________________________
Note: Enclose a signed letter indicating that you have been awarded this amount. $
4. University award from:
Type of award:________________________________________________________________________________________ $
5. Student loan
Note: Provide copy of loan letter. $
TOTAL AMOUNT (Lines 1–5 above) you will have available when you arrive at Florida Tech
(Note that tuition, fees and university room rent are due at registration.) $
BANK OFFICIAL’S CERTIFICATION
Check one or both of the boxes below, as appropriate.
Item 1 o This is to certify that I have read the information provided by the applicant in Item 1 above, that the information is true and accurate, and that the funds
are available as indicated.
Item 2 o This is to certify that I have read the information provided by the applicant in Item 2 above, that the information is true and accurate, and that the funds
are available as indicated.
Bank Official’s Signature and Seal __________________________________________________________________________________________________________
Bank Official’s Name (printed) _____________________________________________________________________________________________________________
Title __________________________________________________________________________________________________________________________________
Name of Bank __________________________________________________________________________________________________________________________
Address of Bank ________________________________________________________________________________________________________________________
PARENT OR SPONSOR CERTIFICATION
This is to certify that I have read the information provided by the applicant in Item 2 above, that the information is true and accurate, and that the funds are
available as indicated.
Sponsor’s Signature and Date _____________________________________________________________________________________________________________
Sponsor’s Name (printed) ________________________________________________________________________________________________________________
Relationship to Student __________________________________________________________________________________________________________________
Address _______________________________________________________________________________________________________________________________
FLORIDA TECH SCHOLARSHIP/AWARD/ASSISTANTSHIP: ___________________________________________________________________________________
Amount awarded: $ _________________________________________
STUDENT CERTIFICATION
I certify that all the information provided on this form, including the total amount of support that will be available is correct and complete, and that I will not
require any additional assistance from Florida Tech.
Student Signature _______________________________________________________________________________________ Date__________________________
150 West University Boulevard, Melbourne, FL 32901-6975 ■ (321) 674-8053 ■ Fax: (321) 728-4570
admission@fit.edu
SA-741-912
Page 2 of 2