Certification of Finances

DENISON
Instructions:
All applicants that are not eligible for federal student aid (non-US citizens or permanent residents) are required to submit this form
with their application for admission.

Please carefully review and complete the application below. We do not require any bank attestation or documentation with this form,
although we may request such documentation on a case-by-case basis. This form can be completed electronically, but it must be
reviewed and hand-signed by both the student and a parent or guardian. If a question is not applicable, please leave it blank. Report
all currency in U.S. dollars (USD).

Contact the Office of Admission at admission@denison.edu if you have any questions or need to make any changes after you submit
this form.

STUDENT INFORMATION

Malak
_________________________ _________________________ Karkas
_________________________
Student’s First Name Student’s Middle Name Student’s Last Name

11/24/2003
_________________________ Morocco
_________________________ Morocco
_________________________
Date of Birth (MM/DD/YYYY) Country of Birth Country of Citizenship

Hay Mly Rachid Building 11 Appt 11B Casablanca

__________________________________________________________________________________________
Permanent Address (Street, City, Country)

__________________________________________________________________________________________
Mailing Address (Street, City, Country) — if different from permanent address

3
_________________________
Size of Household (total family members, including you)

PARENT/GUARDIAN 1 INFORMATION

Abdelaziz
_________________________ _________________________ Karkas
_________________________
Parent/Guardian’s First Name Parent/Guardian’s Middle Name Parent/Guardian’s Last Name

02/18/1963
_________________________ Morocco
_________________________ Morocco
_________________________
Date of Birth (MM/DD/YYYY) Country of Birth Country of Citizenship
deceased 7/21/2021
_________________________ _________________________ _________________________
Occupation Job Title Annual Salary

__________________________________________________________________________________________
Permanent Address (Street, City, Country)

__________________________________________________________________________________________
Mailing Address (Street, City, Town/City, Country) — if different from permanent address

100WEST
COLLEGE I GRANVILLE.
STREET OHIO I 740-587-0810
43023 I DENISON.EDU
PARENT/GUARDIAN 2 INFORMATION

Afifa
_________________________ _________________________ Fadel
_________________________
Parent/Guardian’s First Name Parent/Guardian’s Middle Name Parent/Guardian’s Last Name

5/16/1968
_________________________ Morocco
_________________________ Morocco
_________________________
Date of Birth (MM/DD/YYYY) Country of Birth Country of Citizenship

Housemaker
_________________________ none
_________________________ none
_________________________
Occupation Job Title Annual Salary

Hay Mly Rachid Building 11 Appt 11B Casablanca

__________________________________________________________________________________________
Permanent Address (Street, City, Country)

__________________________________________________________________________________________
Mailing Address (Street, City, Town/City, Country) — if different from permanent address

EXPECTED FINANCIAL SUPPORT

In this table, please report what you are able to contribute each year toward the direct costs at Denison. Direct costs include tuition,
housing, and meals on an annual basis. These costs do not include other expenses, like books, transportation, health insurance, and
incidental expenses, which should be budgeted for separately. Report all currency in U.S. dollars (USD).

First Year Second Year Third Year Fourth Year

Student’s Sources 5000USD 6500USD 6500USD 7000USD
of Funds (Personal
and Parental)
0 0 0 0
Sponsor Funds*

5000USD 6500USD 6500USD 7000USD

Total

*If you are receiving funds from a sponsor, please explain below:

100WEST
COLLEGE I GRANVILLE.
STREET OHIO I 740-587-0810
43023 I DENISON.EDU
ADDITIONAL INFORMATION

If you would like to share any additional information, please do so below:

My country doesn't provide any type of financial help for students.

I and my mom live with my grandmother.
My family spend around 23K USD every year on the monthly expenses. ( household necessities,
utilities, housing, food...)
My mom doesn't own any assets.
My father died about 6 months ago and I can't provide ant documents about his salary or anything
related to him because it's illegal and confidential.
I'm receiving an orphan pension monthly till I'm 21 years old.
My aunt who lives in the US will be my source of emergency funds.

I certify that the information provided on this form and all supporting documentation is true to the best of my knowledge. I understand
that additional documentation may be required to verify any information provided.

_______________________________________ ________________________________________
Student Signature Date Parent/Guardian Signature Date

100WEST
COLLEGE I GRANVILLE.
STREET OHIO I 740-587-0810
43023 I DENISON.EDU