Statement of Financial Responsibility and I-20 Documentation Form

Student Information

Email Address*

First Name*

Middle Name

Last Name*

Birthdate*

Country of Birth*

Country of Citizenship*

Current Mailing Address to Receive your I-20

Country

Street

City

Region

Postal Code

Financial Information

International students must show at least $61,860 in liquid funds with current bank statements or a guarantee of financial support from their sponsor (if applicable). If you have been awarded a scholarship from Willamette University, subtract the amount of your scholarship from $61,860. See the Tuition and Financial Aid page for a detailed list of tuition and fees.

What amount in U.S. dollars will you have available for your use each year in the United States?

What is the specific source of those funds?

What is the name(s) of the person(s) or sponsor(s) from whom you will obtain funds?

Have you applied or expect to apply for assistance, fellowship, or loans from any organization, committee, or educational institution in your home country?

Yes

No

Please describe the details of the additional assitance.

Please upload any documentation regarding assistance, fellowship, or loans.

Dependent Information

Do you have any person or persons (such as a spouse or children) who will be dependent on you for financial support while you are attending Willamette University?

Yes

No

Please describe your plan for supporting your dependent(s) while you are in the United States.

How many dependents rely on you for financial support?

Please use this box to list your dependent(s), their date of birth, and their relationship to you.

Proof of Funding

Please upload your Proof of Funding (bank statements, guarantee of scholarship, etc.) here.

Passport

Please upload a copy of the name/photo page of your passport showing your photograph and the correct spelling of your name.

Signature

By affixing my digital signature below, I certify that the statements on this form are complete and accurate.

Digitally sign your name.

Today's date

Permanent Address in Your Home Country

Country

Street

City

Region

Postal Code