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 ________________

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________________