Certificate of Financial Responsibility for Law/Graduate Students
Not for US citizens or permanent residents of the US
Mail or fax this form to:
International Students and Scholars
MSC 192 - Lewis & Clark College
0615 SW Palatine Hill Road
Portland, Oregon 97219-7899
FAX: 503-768-7301
The U.S. government requires educational institutions to obtain evidence that applicants have adequate funds to pay for their educational and living expenses while studying in the United States. To comply, please complete the financial certificate below by filling in in the amount guaranteed by you or your sponsor. Be sure to attach the required documents to this form.
Applicant's name ____________________________ Country ________________
| Source of Support
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Documentation Required
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Amount Guaranteed
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| Personal funds
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Bank statement, signed by an official of your bank indicating amount of funds available for your proposed period of student
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US$________ per year for ______ years
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| Parent/Sponsor
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Bank statement indicating the amount of funds available for your proposed period of study. Statement of financial responsibility (below) signed by parent or sponsor.
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US$________ per year for ______ years |
Name of Sponsor _____________________________________________________________________
Relationship to applicant ________________________________________________________________
Sponsor's address _____________________________________________________________________
Sponsor's Telephone ________________________ Sponsor's Fax ______________
This is to certify that I will be responsible for the amounts outline above during this student's enrollment at the Law School/Grad School of Lewis & Clark College.
Signature of Sponsor _______________________________Date _______ If you receive scholarship/fellowship funds from your government or a private organization, list the award here and attach a copy of the signed award letter. Amount: $US __________________________
If you receive a loan from your government, a bank or other organization, list the amount here and attach a copy of the signed loan agreement. $US_______________________
I certify that all the statements on this form are true and accurate and that funds will be provided as specified above.
Student's signature_____________________________________Date________________
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Certificate of Financial Responsibility
