Graduate Studies

Financial Statement of Support for International Applicants
Please complete this form and request your bank or sponsor to attach the required documents to it.
The Financial Statement of Support packet should be e-mailed to: grad.credentials@mines.edu or






mailed to: Colorado School of Mines








Office of Graduate Studies

1500
Illinois
Street,
Suite
125

Golden,
CO

80401
If you are not awarded financial aid by the department you will need to submit this form before your visa paperwork can be processed.

Applicant Name: __________________________________________________
Birth Date: _____________________


First

Middle

Last





MM/DD/YYYY





The information given below, to the best of my knowledge, is true and accurate.
Year(s) of funding: 20____, 20____






Signature of applicant: _______________________________________________

Fund Source
Please complete the appropriate section(s) showing the amount of funding you have available for your first academic year of study (9 months).
The amount(s) must total $50,300 for a single student. You must add $5,500 per year for your spouse and $3,500 per year for each child.
These are estimated amounts which should cover your tuition, fees, books, insurance and estimated living expenses for nine months.

(estimates: tuition $31,472, fees $2,128, cost of living $13,500, books & insurance $3,200)

 Personal


Type of Account: ______________________________
Amount available: $_______________(US currency)
Savings,
Checking,
etc.


Type of Account: ______________________________
Amount available: $_______________(US currency)
Savings,
Checking,
etc.


Type of Account: ______________________________
Amount available: $_______________(US currency)
Savings,
Checking,
etc.


Please provide a bank statement showing your average daily balance for the previous 4 months and the type of account in which the
funds are being held. The fund amounts should be converted to US currency.


 Government, College/University, Company/Employer, or International Organization

Name of Sponsor: ____________________________________________________


Amount of Sponsorship: $_________________(US currency)


Length of Sponsorship: ____________________

An official letter from your sponsor must accompany this form detailing the award. The fund amounts should be converted to US
currency.

 Family or Other Source

Name of Family member and/or Other Sponsor:


First
Middle
Last

Amount: $_____________(US Currency)


Signature of Family member and/or Sponsor





Name of Family member and/or Other Sponsor:

First
Middle
Last

Amount: $_____________(US Currency)




Signature of Family member and/or Sponsor
Each family member or ‘other sponsor’ must submit a bank statement showing the average daily balance for the previous 2 months
and the type of account in which the funds are being held. The fund amounts should be converted to US currency.

Each family member or ‘other sponsor’ must also submit the included ‘Affidavit of Support’ stating that they agree to sponsor you, the
length of time their sponsorship covers, and the amount of support.

Graduate Studies

Affidavit of Support - Family Member or Other Sponsor

Applicant Name: _____________________________________________________ Birth Date: ______________________


First

Middle

Last



MM/DD/YYYY
Sponsor’s Name:_______________________________________________________________________________
Sponsor’s Address:_____________________________________________________________________________
_____________________________________________________________________________________________
Sponsor’s Occupation:__________________________________ Annual Salary in US Currency:________________
Relationship to Applicant:_________________________________________________________________________
I certify that I will provide financial support for____________________________________________________________
Name of Applicant


who resides at ________________________________________________________________________________
Student’s Current Address
_____________________________________________________________________________________________
in the amount of $ __________________ per year, for the term of ______________________________________.



(Amount
in
US
Dollars)
(Length
of
Sponsorship. Minimum of nine (9) months.)

Bank Information
Account Type: Checking Savings Other _______________
Date opened: ______________________












(MM/DD/YYYY)

Current balance: $____________________________in US Dollars
Today’s Date:_______________________

(MM/DD/YYYY)


Bank Name: ___________________________________________
Bank Address: ________________________________________________________________________________


Account Type: Checking Savings Other _______________
Date opened: ______________________












(MM/DD/YYYY)

Current balance: $____________________________in US Dollars
Today’s Date:_______________________

(MM/DD/YYYY)


Bank Name: ___________________________________________
Bank Address: ________________________________________________________________________________

I certify that this information is accurate to the best of my knowledge

Name of Sponsor: ____________________________ Signature of Sponsor: ______________________________
Name of Applicant: ___________________________ Signature of Applicant: _____________________________