Certification of Finances Form

Please fill in(typed) all required items, save, and submit

via MyMichiganTech

Personal Information

Surname(s) (as it appears on passport) Michigan Tech Student ID Number (M12345678)

Given Name(s) (as it appears on passport) Date of Birth City of Birth (as it appears on Passport)

Country of Birth Country of Citizenship

Program of Study Proposed term of enrollment

Mailing Address
Address where you would like to have your I-20 or DS-2019 form sent

Street Line 1 Street Line 2:

Street Line 3

City State/Province Post code Country

If you currently hold a valid US visa what is your current visa

Do you currently hold a valid US Visa? type? (leave blank if you do not have a visa)
Yes No

If you are currently studying in the United States with a valid F-1 or J-1 visa, please provide the name of the
institution that is on your I-20 or DS-2019. (leave blank if you do not currently hold a visa)

Visa expiration date SEVIS number

Are you bringing any dependents with you? (If you select No, skip to page 3)
Yes No
Dependent Information
Complete this section only if your spouse or child(ren) are traveling with you. You will also need to provide a copy of each
dependents passport to mygrad@mtu.edu before the dependent I-20s will be issued. You will need to include an additional
$4,000 for a spouse and $2,500 per child in your proof of funding documents.

Dependent - Given Name(s) (as it appears on

Dependent - Surname(s) (as it appears on passport) passport)

Relation to you Dependent - Date of Birth

Country of Birth Country of Citizenship

Dependent - Given Name(s) (as it appears on

Dependent - Surname(s) (as it appears on passport) passport)

Relation to you Dependent - Date of Birth

Country of Birth Country of Citizenship

Dependent - Given Name(s) (as it appears on

Dependent - Surname(s) (as it appears on passport) passport)

Relation to you Dependent - Date of Birth

Country of Birth Country of Citizenship

If you need to include additional dependents, please include their passports in with the ones listed above and email
mygrad@mtu.edu. Please be sure to include their costs into your estimated cost to attend.
Proof of funding

A Certificate of Eligibility (Form I-20 or DS-2019) will be authorized when this form is satisfactorily completed and
adequate funds are guaranteed for the student's educational needs.
Estimated Expenses for 2021-22*
Fall and Spring Semesters
A B
Tuition ** (A=$1,343/credit; B=$1,182/credit) $24,174 $21,276
Fees (student voted fees, international surcharge, and course fees) 1,884 1,884
Living Expenses 9,822 9,822
Books and Supplies (estimated) 600 600
Total for two semesters $36,480 $33,582

*The above schedule is subject to change without notice. Upon arrival, students must have a minimum of $14,000 for immediate
distribution. I understand I will need to meet the health insurance requirement if admitted/enrolled.
**If you are admitted to a program in the College of Engineering or College of Computing you will need to have sufficient funds for column
A. All other programs will need to have equal or greater than column B.

Source of Funds: All funds listed must be documents by official bank statements and/or funding letters. Official
bank statement must be on the institution's letterhead and include and official stamp/seal with the signature of a
bank official and are valid for six months from the date of issue.

Not acceptable sources of funds: Fixed deposits, proof of stock or security holdings, insurance, property,
investment accounts, retirement plans, provident fund accounts, US Government form I-134 or verification of
employment income. If you are unsure if your form of funding will suffice, send an email to mygrad@mtu.edu.

Total Estimated Expenses (Column A or B based on program + Dependents if applicable)

How are you paying for your education? (select all that apply)

Personal Funds Educational Loan Family and/or Friends Home Country Scholarship

Primary source of funds Secondary source of funds

Name of Sponsor (for educational loans include all persons listed on sanction) Name of Sponsor (for educational loans include all persons listed on sanction)

Relationship Relationship

Name of Banking Institution Name of Banking Institution

Amount of support available in US dollars Amount of support available in US dollars

By checking this box, I attest that the information in support of funding my education is to the best of my
knowledge and belief, true, correct, and complete. I understand that if I am found to have made false or
misleading information, I will forfeit my admittance into the university.