Phone 507-389-1822 | Toll-free 800-722-0544
[email protected]
https://mankato.mnsu.edu/future-students/apply/
UNDERGRADUATE FINANCIAL AFFIDAVIT
Financial proof must be provided to comply with U.S. government regulations. Your Financial Affidavit must orginate from your source of support. Submit
this document and supporting financial proof with your application and other admissions documents. Final admission is not granted until University
Admissions is satisfied that all documents are complete and correct. The amounts listed are for the 2020-2021 academic year.
Applicant's Name:
(As it appears on Passport) Last/Family Name First/Given Name Middle Name
Tech ID Date of Birth (MM/DD/YYYY) City & Country of birth Country of Citizenship
I certify with my signature that the total amount of money that I have for my first year of study at Minnesota State Mankato meets the minimum required
for my program (including funds for spouse and children, when applicable) and I can cover the expenses of my entire program. I certify the
information provided is correct and complete and that I shall notify Minnesota State Mankato of any change in my financial circumstances. I
understand that inaccurate information can be cause for terminating enrollment at Minnesota State Mankato.
Student signature Date
Part 1
Do you expect to come to the U.S.: With Children
Dependents (if applicable):
Family (Last) Name Given (First) Name Date of Birth (mm/dd/yyyy) City/Country of Birth Relationship
Relationship
Relationship
If you are currently outside the U.S., what type of visa do you wish to receive? F-1 J-1
If you are currently in the U.S., what type of visa do you hold?
If you are currently in the U.S. on an F-1 or J-1 visa, which school, college, university or institute issued your I-20 or DS-2019?
Name and address of institution
TUITION AND ESTIMATED LIVING EXPENSES FOR 9 MONTHS
ESTIMATED EXPENSE ESTIMATED EXPENSE
(Advanced/Lower Level)
$18,160 TUITION & FEES $11,258/$10,120
$9,336 LIVING EXPENSES $9,336
$1,400 BOOKS & SUPPLIES $1,400
$2,000 HEALTH INSURANCE $2,000
PERSONAL EXPENSES $1,700
$1,700
$32,596 $25,694/$24,556
(Based upon full-time status = enrolled in 12 credits per semester.)
AFFIDAVIT: PAGE 1 OF 2
Part 2
DECLARATION OF FINANCIAL SUPPORT
REQUIRED DOCUMENTATION
Copy of bank statement
$7,420 (Undergraduate) x Type of award: INTERNATIONAL MAVERICK SCHOLARSHIP
$1,200 (Advanced IEP)
$0 (Lower Level IEP)
Copy of letter or document from government/agency
Name of organization:
This amount should add up to the tuition and estimated living expenses on page 1 of the Affidavit.
CERTIFICATION OF AGREEMENT BY STUDENT
APPLICANT: Please provide the REQUIRED signature and date below. By signing here, you are agreeing to the following statement.
I certify that the information provided is correct and complete and that I shall notify Minnesota State University, Mankato of any changes in my financial
circumstances. I understand that inaccurate information can be cause for terminating enrollment at Minnesota State University, Mankato.
CERTIFICATION OF AGREEMENT BY SPONSOR
, am able and willing to provide financial support to
Name of student
per year while she/he studies at Minnesota State University, Mankato.
Are you currently sponsoring another student in the U.S.? If yes, please provide full name of student and institution they are studying at.
_________________________________________________________________________________________________________________________________________________________________
A member of the Minnesota State system and an Affirmative Action/Equal Opportunity University.
This document is available in alternative format to individuals with disabilities by calling the College of Graduate AFFIDAVIT: PAGE 2 OF 2
Studies and Research at 507-389-2321 (V), 800-627-3529 or 711 (MRS/TTY). UPDATED: 3/21
