Student Finance Declaration Form - University of Connecticut
ISSS 926 Financial Declaration Form 1
Rev. 9/11/2014 rb
INTERNATIONAL STUDENT AND SCHOLAR SERVICES (ISSS)
University of Connecticut 2011 Hillside Road, Unit 1083; Storrs, CT 06269 Phone: 860-486-3855 Fax: 860-486-5800 Web: http://isss.uconn.edu
University of Connecticut (UConn) ‐ International Student Financial Declaration Form
I hereby declare that I will have funding available to cover estimated expenses for the duration of my program at UConn. I
have attached support documentation to demonstrate I can readily meet expenses for at least the first academic year of
study in my program, and I expect to maintain the same level of funding for future years in my program, acknowledging
that UConn fees may increase in future years. I understand that I am responsible for all additional expenses incurred if I
decide to stay in the U.S. when my program does not require summer/winter enrollment in its curriculum. I declare that
any funding support documentation I have submitted electronically or as copies are taken from official original documents
or were issued to me or my financial sponsor from original sources.
Degree Level: Bachelor’s Master’s Doctorate Professional ESL Non‐Degree/Exchange
Field of Study:
________________________ __________ ___ _____________ ________________
Student’s Name Signature of Student Today’s Date
EQUIRED IF YOU ARE FUNDED BY AN INDIVIDUAL
I, _____________________________ agree to provide _______________________________ , my
(sponsor’s name) (student’s name)
_____________________________ , with financial support to study at the University of Connecticut.
(relationship to student)
Specifically, I will provide for each year of study (choose all that apply):
___ $ ____________ USD per year and I provided my financial statement
___ room at my residence at no cost
___ board at my residence at no cost
Sponsor’s Name: ______________________________
Sponsor’s Signature: ____________________________ Date: ____________________
Notary Public ‐ required if the financial sponsor is in the U.S.
Sworn to me on this day of (month, year): ________________________________________
Please submit documentation for ALL sources of expected funding. This may include bank statements, scholarship/fellowship letter, Graduate
Assistantship letter. Documentation must meet the following guidelines:
Issued within past 3 months
For bank statements, must identify the account holder and currency (can be local currency)
For personal and family funding, must be liquid funds such as savings/banking statements or certificates of deposit (no investment fund
statements, salary/income confirmation, property verification, credit lines, etc.).
If you are being funded by a personal sponsor (like a family member) your personal sponsor must complete Part 2: Personal Sponsor
Declaration of this form.
Please consult www.isss.uconn.edu > Students > Financial Declaration and Cost of Attendance to see the minimum amount you are required
to demonstrate in funding support documents.
Student Finance Declaration Form - University of Connecticut PDF
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