Application for Financial Assistance
for the 201415 Academic Year
INTERNATIONAL STUDENTS
Office of Admission Franklin & Marshall College
P.O. Box 3003 Lancaster, PA 17604-3003
(717) 291-3951
FAX # (717) 291-4389
[Link]
Students who wish to be considered for financial assistance by Franklin & Marshall College for the 201415 academic year must complete and return
this form, with the admission application, to the Office of Admission, Franklin & Marshall College, P.O. Box 3003, Lancaster, PA 17604-3003, USA.
Please Note: The admission process for international students may be influenced by their ability to be financially self-supporting.
Ha
Phong
The
1. Your name _________________________________________________________________________________________________________________________________________________________________
last (family)firstmiddle
2. Permanent home address (your familys home)
_____________________________________________________________________________________________________________________
12/450 Bach Dang, Hoan Kiem, Hanoi, Vietnam
______________________________________________________________________________________________________________________________________________________________________________
3. Your date of birth
08
25
1996
//
________________________________
month/day/year
Vietnam
4. Country of citizenship ___________________________________________________
Ha Trong Kieu
5. Your fathers name ___________________________________________________________________________________________________________
43
Age ___________________________________
Teacher
His occupation/title ______________________________________________________________________________________________________________________________________________________
Hanoi College of Education
His employer ______________________________________________________________________________________________________________________________________________________________
His home and business e-mail addresses home ______________________________________________ bus. _______________________________________________________
Nguyen Thi Hoai Le
43
6. Your mothers name __________________________________________________________________________________________________________
Age ___________________________________
Tailor
Her occupation/title ______________________________________________________________________________________________________________________________________________________
self-employed
Her employer _____________________________________________________________________________________________________________________________________________________________
Her home and business e-mail addresses home ______________________________________________ bus. _______________________________________________________
7. Your parents marital status:
[ x ] married
[ ] divorced/separated
If parents live separately, a separate form must be completed for each household (you may duplicate this form).
8. Name the members of your family living in your parents household (including ALL dependent members of the household):
Educational information, 201415
Full name of family member
Age
Relationship to you
Ha Trong Kieu
43
Father
Nguyen Thi Hoai Le
43
Mother
Ha The Phong
17
Ha The Duy
13
Brother
Name of school
or college
Trung Vuong
Year of
attendance
Tuition and
fees
800
Room and
board
Financial
aid
Amount of
Parents
contribution
800
Secondary School
9. How many persons, including you, depend on the income of your parents for daily living?
4
____________________________
10. How many of these persons depend on the family income for their educational costs?
2
____________________________
AFA1
PLEASE CONVERT ALL ANSWERS TO UNITED STATES DOLLARS
21,115 = $1.
11. What is the present exchange rate of your countrys currency to the U.S. dollar (for example, 0.7485 Euro = $1)?VND
______________
12. During the past year, how much of your household income (before taxes or expenses) came from the following sources?
16,000
3,978
0
fathers work
$ ______________________
mothers work
$ ______________________
your work $ __________
0
0
0
family business/real estate
$ ______________________
interest or dividends
$ ______________________
other
$ __________
0
pension/annuity/retirement $ ______________________
13. What did your parents spend or parents employers provide to meet your living expenses during the past year? Specific amounts are needed.
PARENTS
EMPLOYERS
PARENTS
EMPLOYERS
0
1,500
rent or mortgage/housing
$ ________________
$ ________________
automobile (not fuel)
$ ________________
$ ________________
800
5,400
food
$ ________________
$ ________________
medical expenses
$ ________________
$ ________________
600
1,400
clothing
$ ________________
$ ________________ entertainment
$ ________________
$ ________________
800
1,300
household necessities
$ ________________
$ ________________ vacations
$ ________________
$ ________________
0
1,400
utilities
$ ________________
$ ________________ servants
$ ________________
$ ________________
2,000
insurance (health or property)
$ ________________
$ ________________
educational expenses
$ ________________
$ ________________
600
0
2,000
taxes $ ________________
$ ________________
retirement/savings $ ________________
$ ________________
social club memberships*
$ ________________ $ ________________
other (specify)
$ ________________ $ ________________
*List social clubs to which your parents belong: ________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________________________________________________________
14. Does your family own its own home? ___________________________________________________________________________________________________ [x ]yes [ ]no
inherited
inherited
What year was it purchased? ________________________
What was the original purchase price? $ _____________________
94,719
What is the present sale value?
$ _____________________
What is owed on home?
$ ______________________
15. a.
Give the present value of other family assets in your country:
0
land and buildings (other than family home) $ ______________________
0
investments (such as stocks and bonds)
$ ______________________
0
money owed to your family (explain*)
$ ______________________
b.
Do you or your parents have money, properties or assets in another country? [ ] yes [x ] no
If yes, in which countries are these assets held? ____________________________________________________________________________________________________________
0
List the assets and their values in U.S. dollars ____________________________________________________________________________________________________________
If the assets above produce no income in 12, please explain.*
47,848
savings $ ______________________
0
family business $ ______________________
other (explain*) $ ______________________
0
*Explanations _______________________________________________________________________________________________________________________________________________________
16. Does your family employ other people? [ ] yes [x ] no If yes, how many in the home? _______________ In the family business? ________________
17. If your family owns automobiles, please report the make (VW, Fiat, etc.) and the year of manufacture:
Huyndai, 2010
______________________________________________________________________________________________________________________________________________________________________________
18. What amounts will be available for your education in the United States per year (excluding travel to and from the U.S.)?
FIRST YEAR
SECOND YEAR
THIRD YEAR
FOURTH YEAR
Family savings
11,000
11,000
11,000
11,000
Relatives/friends
Sponsor
Family income
2,000
2,000
2,000
2,000
Government
Explain: ____________________________________________________________________________________________________________________________________________________________________
19. List agencies/foundations/government to which you are applying for financial aid and amount applied for:
______________________________________________________________________________________________________________________________________________________________________________
20. List other U.S. colleges to which you are applying:
______________________________________________________________________________________________________________________________________________________________________________
CERTIFICATION We declare that the information on this form is true, correct, and complete. This form should be accompanied by a certificate/tax form from employer, bank or government verifying salaries listed above. WARNING: Providing false information may jeopardize a
students visa status and furthermore may result in Franklin & Marshall revoking its initial decision to enroll the student.
signature of father
________________________________________________________________________________________________ date ______________________________________________
signature of mother
________________________________________________________________________________________________ date ______________________________________________
signature of student
________________________________________________________________________________________________ date _______________________________________________
AFA2
