Graduate Studies

Financial Statement of Support for International Applicants
Please complete this form. Request your bank or sponsor to attach the required documents to it.
The Financial Statement of Support packet should be mailed to: Colorado School of Mines








Office of Graduate Studies
1500
Illinois
Street,
Suite
125







Golden, CO 80401
If you are not awarded financial aid by the department you will need to submit this form before your visa paperwork can be processed.

Applicant Name: __________________________________________________
Birth Date: _____________________


First

Middle

Last





MM/DD/YYYY





The information given below , to the best of my knowledge, is true and accurate.
Year(s) of funding: 20____, 20____






Signature of applicant: _______________________________________________

Fund Source
Please complete the appropriate section(s) showing the amount of funding you have available for your first year of study (12 months). The
amount(s) must total $49,000 for a single student. You must add $5,500 per year for your spouse and $3,500 per year for each child.
These are estimated amounts which should cover your tuition, fees, books, insurance and estimated living expenses for one year.

(estimates: tuition $33,250, fees $1,050, cost of living $12,750, books & insurance $1,950)

 Personal


Type of Account: ______________________________
Amount available: $_______________(US currency)



Savings, Checking, etc.


Type of Account: ______________________________
Amount available: $_______________(US currency)



Savings, Checking, etc.


Type of Account: ______________________________
Amount available: $_______________(US currency)



Savings, Checking, etc.


We require a bank statement showing your average daily balance for the previous 6 months and the type of account in which the
funds are being held. The fund amounts should be converted to US currency.


 Government, College/University, Company/Employer or International Organization

Name of Sponsor: ____________________________________________________


Amount of Sponsorship: $_________________(US currency)


Length of Sponsorship: ____________________

An official letter from your sponsor must accompany this form detailing the award. The fund amounts should be converted to US
currency.

 Family or Other Source

Name of Family member and/or Other Sponsor:


First


Middle


Last

Amount: $_____________(US Currency)


Signature of Family member and/or Sponsor





Name of Family member and/or Other Sponsor:

First


Middle


Last

Amount: $_____________(US Currency)



Signature of Family member and/or Sponsor

Each family member or ‘other sponsor’ must submit a bank statement showing the average daily balance for the previous 6 months
and the type of account in which the funds are being held. The fund amounts should be converted to US currency.

Each family member or ‘other sponsor’ must also submit an Affidavit stating that they agree to sponsor you, the length of time their
sponsorship covers and the amount of support per year. This affidavit MUST be notarized.