Two Year MBA Financial Certificate
One Semester 2012-2013 Academic Year
This form must be completed and returned to:
Harriet Ruskin
[email protected]
Fax 1.404.712.9648
As an international applicant, you are required to certify that you have sufficient funds to
cover your expenses while attending Emory University. Please Note: This form must be
completed by every international student who intends to enroll. This includes applicants
who are awarded teaching assistantships, research assistantships and other university
awards. The admissions process is not complete until this form has been completed
and returned to Emory. Visa documents are issued only when all admission procedures
have been satisfied.
For One Semester of the Two Year MBA Tuition, Fees and Expenses for 2012-13 are (US Dollars):
Tuition
$Waived
Fees
$257
Living Expenses
$9064 (estimate)
Health Insurance Premiums
$1080 (estimate)
Textbooks/Supplies
$1050 (estimate)
Subtotal
Spouse (if applicable)
(+$8,400)
Children (if applicable) (+$4200 per child)
$11,451
$
$
Total
$
A married student with a family will need to show an additional $8,400 per year
($700 per month) for the spouse and $4,200 per year ($350 per month) for each
child.
In computing your expenses, you should bear in mind that students holding Students (F)
or exchange Visitor (J) visas will not be authorized to work except under extraordinary
circumstances. Therefore, the applicant should not look to employment, either part-time
during the academic year or full-time during the summer, as a significant means of
support while at Emory University. Under no circumstances are students permitted to
work full-time during the academic year. Spouses of F-1 student visa holders are not
permitted to work under any circumstances. Please note that your spouse may apply for
work permission only if you hold a J-1 Exchange Visitor visa, and then only for his or her
and the children’s support. The spouse of a J-1 Exchange Visitor is permitted to work
only with approval from the U.S. Citizenship and Immigration Service; such approval is
not given routinely.
Two Year MBA Financial Certificate
One Semester 2012-2013 Academic Year
Name:
LAST (Family) Name
First (Given) Name
Middle Name
Address:
City and
Country of Birth:
A. Check appropriate box:
o I plan to come alone
o I plan to bring the following dependents with me (for each dependent, list:
relationship, date & place of birth, nationality, date of issue & expiration date of
passport)
Dependent 1
Name:
Relationship:
Date & City/Country of birth:
Nationality:
Date of issue & expiration of passport:
Dependent 2
Name:
Relationship:
Date & City/Country of birth:
Nationality:
Date of issue & expiration of passport:
Dependent 3
Name:
Relationship:
Date & City/Country of birth:
Nationality:
Date of issue & expiration of passport:
Two Year MBA Financial Certificate
One Semester 2012-2013 Academic Year
Dependent 4
Name:
Relationship:
Date & City/Country of birth:
Nationality:
Date of issue & expiration of passport:
B. I am applying for admission to Emory for: (circle one) FALL SPRING of 201___
Check appropriate box
o I do not expect to be at Emory for more that one year
o I expect my program of study to require _____years
o I expect to remain in Atlanta, during summer periods
o I expect to attend Summer School Session.
Two Year MBA Financial Certificate
One Semester 2012-2013 Academic Year
SOURCES OF SUPPORT: Amounts (INDICATE IN U.S. DOLLARS)
Source of Support
1. PERSONAL AND /OR FAMILY
SAVINGS:
Name of
bank:__________________________________
Note: A letter from the bank should accompany
your statements for the past 3 months. Please
see below for the specifications.
2. PARENTS AND/OR SPONSORS:
Print name of each person:
Note: You must provide a letter from each
person/sponsor required below OR a bank
certification as above and attach current
“original” bank statement to this form.
3. YOUR GOVERNMENT
Print name of Agency:
Note: Enclose with the form a signed letter of
award.
4. UNIVERSITY AWARD FROM
Print type of award:
Note: if this is a Goizueta Business School
scholarship please attach a copy of your letter
5. OTHER
Please specify:
Note: Enclose a signed “original” affidavit
from authorized person to certify accuracy.
6. TOTAL
Note: Must equal or exceed the total amount
from the 1st page of this form.
Amount in $USD
Two Year MBA Financial Certificate
One Semester 2012-2013 Academic Year
All applicants must show proof of finances. Please obtain an official letter from the bank
or financial institution in which you, and/or your sponsor, have available funds. This
letter should be written on official letterhead, in English, and signed by a bank official.
This letter should state the date the account was open, the currency type, and specifically
state an amount this is currently in the account. Additionally the letter should include the
average balance for the past three months or the bank official should attach statements for
the past three months). Bank letters dated more than two months from the date of
submission to (Goizueta Business School) are considered outdated and are not
acceptable.
The Total amount of money I expect to have upon arrival at Emory for fees including,
tuition, student fees, transportation, housing deposits and utility deposits is:
U.S. $_______________
This certifies that the total amount of money that I have available for my semester of
study at Emory University (including funds for spouse and children if applicable) is
US$______________
Furthermore, I certify that the above information is correct and complete and that I will
not require additional assistance from Emory University.
Signature of Student:
Date: