Financial Certification Form for F-1 student visa applicants (2022-2023)

It is each applicant’s responsibility to demonstrate sufficient funding for all academic and living expenses during their entire course of study at York College of Pennsylvania in the United States. In order to obtain an I-20, Certificate of Eligibility for Nonimmigrant Student Status, which is required for the F-1 student visa status, the applicant must submit documentary evidence of financial support for the entire period of studies in the United States.

2023-2024 Estimated cost of attendance (COA) for ONE academic year (8 months)
DOES NOT INCLUDE COSTS ASSOCIATED WITH SUMMER OR INTERSESSION STAY IN THE U.S.

Tuition and Fees*	$24,606
Room & Board**	$12,780
Books & Supplies	$1,200
Medical Insurance	$1,500
Personal & Travel	$2,100
Total COA	$42,186
Dependent Expenses***	+$5,000 (per dependent)

*Additional fees may be incurred including Undergraduate Differentials for Communications, Engineering, Nursing, Respiratory Therapy, Computer Science, and Hospitality majors. For cost details visit our tuition and fees page on our website.
**Lowest room and board cost for double occupancy and minimum required meal plan. Cost will vary for single rooms, suites, and apartments on-campus, or other living arrangements off-campus for commuter students.
*** Student’s spouse or children traveling with the student are considered dependents.

1. Personal Information

Family (Surname)

Given (First)

Middle Name

Country of Birth

City of Birth

Date of Birth

Country of Citizenship

2. Reason for Submitting a Financial Certification Form

Please choose from the options below:

To enter the U.S. as a new student on F-1 status

To Transfer your SEVIS record to York College of Pennsylvania from another U.S. institution.

To Apply for a Change to F-1 status in the U.S.

Will you enter by yourself or with dependents?

Self

With Dependents (spouse or children)

3. Foreign Home Address

Country

Street

City

Region

Postal Code

4. Mailing Address for I-20 form (if different from Home)

Country

Street

City

Region

Postal Code

5. Funding Information

The total financial support necessary for your first academic year of studies must be documented and available prior to enrollment. Indicate the total amount of funding (in U.S. Dollars) available from each source for your FIRST academic year. Total amount must cover the estimated cost of attendance listed above.

Self/Personal/Parent(s) Funds (in U.S. Dollars - ex: $00.00) - Submit the account holders bank statement

Family, or Sponsor(s) Funds (in U.S. Dollars - ex: $00.00) - Submit Affidavit of Support in addition to Financial documents. If there are no Family, or Sponsor(s) funds please leave blank

Full Name

Relationship

Full Name

Relationship

Scholarships (in U.S. Dollars - ex: $00.00) - Submit a copy of your award letter or notification for any non York College awards. If there are no scholarships please leave blank.

Other (in U.S. Dollars - ex: $00.00) - If there is no additional funding please leave blank

Please specify Source of funding

The financial support necessary for the remaining years of studies must be documented through bank statements, employment wages, verification letters, income tax returns, investments, etc. Indicate the total estimated amount of funding available for EACH academic year.

The TOTAL AMOUNT of money (in U.S. Dollars - ex: $00.00) that I have available for each academic year of study is:

Do you plan to remain in the U.S. during the summer or during intersession (December & January)?

Yes

No

For additional cost(s) associated with your stay during summer or intersession visit our tuition and fees page.

6. Student Certification

I certify that the amount of funds indicated in this form are available for my studies at York College of Pennsylvania for my first academic year and that funds from the same or similar sources will be available for the next 3 years of studies.

By typing your name below you agree and certify that all the information provided above is accurate to the best of your knowledge.

Student E-Signature
Please type your full name

Parent E-Signature (if under 18)
Please type your full name

Date