ࡱ> y cbjbjcc 8 f f@  8-nn$ ,,,,,,,$2/1,i>#>#>#,B-&&&>#:,&>#,&&:*,;+`T(x#* ,X-0-*R2#2;+2;+d}!Z!@&"4K"}!}!}!,,<%}!}!}!->#>#>#>#2}!}!}!}!}!}!}!}!}! X P: UNIVERSITY OF LOUISIANA AT LAFAYETTE GRADUATE SCHOOL CONFIDENTIAL FINANCIAL INFORMATION FORM International students must be able to furnish proof of financial responsibility to meet educational and living costs. The University cannot guarantee financial support to international graduate students or assume responsibility for obtaining financial aid. To view a list of estimated expenses, please visit  HYPERLINK "http://gradschool.louisiana.edu/?q=fif" http://gradschool.louisiana.edu/?q=fif. An I-20 or DS-2019 for graduate admission will not be issued unless this financial form is completed and returned, along with the necessary supporting documents verifying required funds. Section I: General Information FORMTEXT       FORMTEXT       FORMTEXT      Last Name / SurnameFirst / Given NameStudent ID Number FORMTEXT      Street or Box FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT      CityStateCountryZip or Pin CodeVisa Requested (Check one) FORMCHECKBOX  Student (F) I-20  FORMCHECKBOX  Exchange Visitor (J) DS-2019 Section II: Funding How much money (in U.S. Dollars) will you have available while in the U.S. for each academic year (9 month period)?1. PERSONAL FUNDS$ FORMTEXT       $2. FAMILY FUNDS$ FORMTEXT       $3. FUNDS FROM UNIVERSITY$ FORMTEXT      4. FUNDS FROM INTERNATIONAL ORGANIZATION$ FORMTEXT      NAME OF ORGANIZATION FORMTEXT      5. OTHER SOURCES OF FUNDING$ FORMTEXT      NAME OF OTHER SOURCE(S) FORMTEXT      TOTAL SUPPORT AVAILABLE$ FORMTEXT      This form must be accompanied by an original signed letter and/or bank certification from the listed source(s) above. (English translation required, with total amount available indicated in U.S. dollars) Section III: Dependents (Optional) List below all persons who will be financially dependent on you and will accompany you to the U.S. For each person listed below, please submit a copy of his or her passport and provide additional documentation verifying relati5]^  ǸǬǛ{nbSDDShqhXhjMB*CJaJphhqhXhkNB*CJaJphh!;>B*CJaJphh2(h2(0JCJaJ&jh2(B*CJUaJphh2(B*CJaJph jh2(B*CJUaJphhUKzB*CJaJphh]h0B*CJaJphh]hjB*CJaJphhjhjCJaJh!;>ho/B*CJaJphh!;>h QB*CJaJph5]^` b "  p$7$8$H$IfHkd$$IfT4)*)    *)44af4ytT$If$a$$a$gdUKzgdj , > P \ ^ ` b 𴥓ufRf;R,jRhBhx"B*CJUaJph&jhBhx"B*CJUaJphhBhx"B*CJaJph hBhB5B*CJaJphh hB5B*ph#h]ho/5B*CJ \aJ phh!;>ho/B*CJaJphhqhXho/B*CJaJphhqhXhkNB*CJaJphhqhXh!;>B*CJaJphhqhXh]B*CJaJphhqhXh:'B*CJaJph          " $ ìÛxbbbbb+jhx"B*CJUaJmHnHphu,j<hhx"B*CJUaJphhx"B*CJaJph jhx"B*CJUaJph,jhBhx"B*CJUaJphhBhx"B*CJaJph&jhBhx"B*CJUaJph1jhBhx"B*CJUaJmHnHphu"" $ & N t v E88888 8H$Ifkd$$IfT4֞tWk!("()        *)44af4ytu\T$ & L N r t v 򸦸zzzzzobPChYHmh B*CJph#h h 5B*CJ\aJphhBh 5B*phh h B*ph-jhYHmhx"B*CJUmHnHphu(jhYHmhx"B*CJUph"jhYHmhx"B*CJUphhYHmhx"B*CJphhhB*CJaJphhBhB*CJph hBhB*CJ\aJphhYHmhB*CJph keee$Ifkd$$IfT4rWk!:")   *)44af4ytx"T &[kd$$IfT40) r( *)44af4ytx"T 8$ $7$8$H$Ifnkd$$IfT4F() h'  *)    44af4ytu\T   > @ h j $If           , . 0 2 4 6 8 : < > @ B V X Z \ ^ ` b d f h j l 񾾾񾾾񾾾r񾾾(jh<h B*CJUph(jBh<h B*CJUph(jh<h B*CJUphhYHmh B*CJph'jh B*CJUmHnHphu(jVh h<B*CJUphh B*CJphjh B*CJUph,    ³nZCZ,j( hBh B*CJUaJph&jhBh B*CJUaJph)hBh 56B*CJ\]aJph#hBh 5B*CJ\aJphhBh B*CJaJphhYHmh B*CJaJphhBh 5B*aJphhYHmhB*CJphhYHmh B*CJphjh B*CJUph'jh B*CJUmHnHphu kd.$$IfT4 !"() =   *)$$$$44af4ytu\T Ekd_ $$IfT4ֈ"() +   *)44af4ytx"T 8 $7$8$H$If 23cde{_]W$Ifkd $$IfT4r W&)       *)44af4ytx"T \ 4$If 01234BCDFbcdez{|}κΣΖxm`N9N)hYHmh556B*CJ\]aJph#hYHmh55B*CJ\aJphhYHmh5B*CJphh ho/B*phh hU5B*phh hB5B*phh]hYHmh B*CJph,j hBh B*CJUaJph&jhBh B*CJUaJphhBh B*CJaJph#hBh 5B*CJ\aJph hBh B*CJ\aJph{|}G== $If[kd_ $$IfT4 0(  (  ))44af4ytUT $$Ifa$gdNs $$Ifa$Hkd $$IfT4())    ))44af4yt {T   ~oePo<<<<haB*CJphhYHmhaB*CJphhYHmh5B*CJph#hYHmh55B*CJ\aJphhNs5B*CJ\aJphh!;>5B*CJ\aJphh55B*CJ\aJph:>fhe[[ $Ifkd $$IfT4ra4(( %  ))44af4yt {T$If :<>@TVXZ\^`bdfhjlnpǸvvvvvaPǸ h!;>a*䴳a)۱᳾a56B*䴳]a'a*䴳Ա(᳧a<B*CJUphhaB*CJphjhaB*CJUphhaha5B*CJphha5B*CJphh!;>haB*CJph#hYHmha5B*CJ\aJphhYHmhaB*CJphhjpkaa[[[$If $Ifkd$$IfT4ra4(( %  ))44af4yt {T*,.0DFHJLNPRTVXZ\ܻ܉tܻggT$jh!;>55B*p!;>55B*(a<B*CJUphhaB*CJphha5B*CJphh!;>a*䴳aa5B*䴳۱᳾a*䴳'a*䴳Աa*䴳(a<B*CJUph*.VXkaa[[[$If $Ifkd$$IfT4ra4(( %  ))44af4yt {TXZ\kaaa[[$If  $Ifkd]$$IfT4ra4(( %  ))44af4yt {T  Ȱ񣘘teVLL7(jyhah<B*CJUphhaB*CJphjhaB*CJUphhaha5B*CJphha5B*CJphh!;>ha5B*phhYHmhaB*phhYHmh5B*phh!;>h55B*ph/jh!;>h55B*U\mHnHphu$jh!;>h55B*U\ph*j1h!;>h55B*U\phh!;>h55B*\phkee___$If$Ifkd$$IfT4rg 4(   ))44af4yt {T  "PRThjlnprtvxz|~òàËtttttgg\T\haB*phhYHmhaB*phhYHmh5B*CJph-jh!;>h5B*CJUmHnHphu(jh!;>h5B*CJUph"jh!;>h5B*CJUph h!;>h5B*CJ\aJphh!;>h5B*CJphhYHmhaB*CJph'jhaB*CJUmHnHphujhaB*CJUph "Rz|~keeeee$Ifkd$$IfT4ra4(( %  ))44af4yt {T~kbb\\\$If $Ifgdakd7$$IfT4r4(    ))44af4yt {T.BD̷֣֖zzpaO@OOhqhX5B*CJ\aJph#hYHmhUKz5B*CJ\aJphhUKz5B*CJ\aJphhUKzB*CJphhYHmh!;>B*CJphh!;>5B*CJ\aJphhYHmhaB*CJph'jhaB*CJUmHnHphu(j hah<B*CJUphhaB*CJphjhaB*CJUphhaha5B*CJphha5B*CJphkee$Ifkd$$IfT4Pr 4(( %  ))44af4yt {TBCD0nkd$$IfT4F((  `'   ))    44af4yt {T$If[kdU$$IfT4m0((u(  ))44af4yt {T  @ABCDEijklۿzhVGV6 hUhN`[B*CJ\aJphh!;>5B*CJ\aJph#h hN`[5B*CJ\aJph#hN`[hN`[5B*CJ\aJphhN`[hN`[B*\]phhd1hBB*CJaJphhN`[hB5B*\phh]h B*\phhYHmhUKzB*CJphhUKzB*CJph#hUKz56B*CJ\]aJph)hYHmhUKz56B*CJ\]aJphhUKz5B*CJ\aJphDEijkl[[[zl $7$8$H$IfgdN`[jkd$$IfT4    ('(  0    4 af4yt {T$$7$8$H$Ifa$gdB $7$8$H$a$ OZ|[~[[[[[[\$\&\B\\\^\b\f\p\|\\\\\\\\ͻzm^ThN`[B*CJphjhN`[B*CJUphhYHmhN`[B*CJphhYHmhrAB*CJphhqhX5B*CJphh]hrA5B*CJphhN`[hN`[B*phhN`[hN`[B*\]ph#hN`[hN`[B*CJ\]aJphhN`[B*CJ\]aJphhqhXB*CJ\]aJphU#hUhN`[B*CJ\]aJphonship (i.e., birth certificates for children, marriage certificate for spouse). Additional financial support for dependents must be submitted ($1,000 for each child and $2,000 for spouse). SEVP now has a City of Birth requirement for all dependents. Name (Last, First)Date of BirthRelationshipCity and Country of Birth FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       I have read and carefully reviewed the estimated expense list provided with this form. I have made the necessary arrangements to meet all my expenses throughout my stay at the University. I certify that the information provided is true and correct. I fully understand that presentation of false information may make me ineligible for admission and enrollment at UL Lafayette. APPLICANT SIGNATURE ___________________________________ DATE ___________________ RETURN TO: UL LAFAYETTE GRADUATE SCHOOL, P.O. Box 43716, Lafayette, LA 70504-4610 Revised 02-17-2020     [[\&\B\\\\\nhhhhhh$IfkdT$$IfT4    6F((' `'  0        4 af4yt {T\\\\\]5////$IfkdS$$IfT4    ֈ4 (('H8 0    4 af4ytqhXT\\\\\\\\\\\\\\\\\\\\\\\\]]]]] ] ]]]$]&](]*],].]0]2]4]6]8]:]ܻܱܻܱܻܱrܻ(jh]hN`[B*CJUph(jvh]hN`[B*CJUph(jh]hN`[B*CJUphhN`[B*CJphhYHmhN`[B*CJph'jhN`[B*CJUmHnHphujhN`[B*CJUph(jhN`[hN`[B*CJUph,]6]8]:]<]/& $IfgdAEkdb$$IfT4    ֈ4 (('H8 0    4 af4ytqhXT$If:]<]>ձձݱܱڱʱı]]]]]]]]]]]]]]]]]]]]]]]]]]]㰰ٛ㰰ن㰰ٱ㰰(]󱷸*䴳(]󱷸*䴳(]󱷸*䴳'󱷸*䴳Ա(󱷸󱷸*䴳󱷸*䴳󱷸*䴳۱᳾󱷸*䴳,<]d]]]]] $IfgdAE]]]]]]]]]]^^^^^ ^ ^ ^"^$^&^(^*^,^.^0^2^4^H^J^L^N^P^R^T^V^X^Z^\^p^r^t^v^x^z^㰰ٛ㰰ن㰰q㰰(j #h]hN`[B*CJUph(j"h]hN`[B*CJUph(j"h]hN`[B*CJUph'jhN`[B*CJUmHnHphu(j!hN`[hN`[B*CJUphhN`[B*CJphjhN`[B*CJUphhYHmhN`[B*CJph,]]] ^2^5,,, $IfgdAEkdq $$IfT4    ֈ4 (('H8 0    4 af4ytqhXT2^Z^^^^,kd#$$IfT4    ֈ4 (('H8 0    4 af4ytqhXT $IfgdAEz^|^~^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^____Űśņq(j&h]hN`[B*CJUph(j%h]hN`[B*CJUph(j-%h]hN`[B*CJUph(j$hN`[hN`[B*CJUphhN`[B*CJphhYHmhN`[B*CJphjhN`[B*CJUph'jhN`[B*CJUmHnHphu,^^^^_(_*_ $IfgdAE____ _"_$_&_(_*_,_._0_2_4_6_8_:_<_` ``H````aXaaaabbb.b0bqbho/B*CJ\]aJphhUKzB*CJ\]aJphh"]B*CJ\]aJphhd1B*CJ\]aJph#hd1ho/B*CJ\]aJph h$-hU5B*CJaJphhrAhrAB*CJaJphhYHmhN`[B*CJph'jhN`[B*CJUmHnHphujhN`[B*CJUph#*_,_._0_2_5,,, $IfgdAEkd&$$IfT4    ֈ4 (('H8 0    4 af4ytqhXT2_4_6_8_:_,kd'$$IfT4    ֈ4 ((' H 8     0    4 af4ytqhXT $IfgdAE:_<_0b2bbbcccccccccccc$a$gd2( $7$8$H$a$gdjgdj  7$8$H$gdd1 7$8$H$gdU0b2bbbbbcTc\ccccccccccccccccccccccccϻϩ{soosoosoosooo{hjhUhuEhjB*CJphhuEh2(B*CJphhqhXB*CJphhNsB*CJph#h!;>hj5B*CJ\aJphhqhXCJaJh!;>hj5CJaJh!;>hjCJaJho/B*phhYHmho/B*ph#hd1h!;>B*CJ\]aJph6&P1h:pd1/ =!"#$% DyK yK fhttp://gradschool.louisiana.edu/?q=fifyX;H,]ą'cy$$If!vh#v*):V 4*),5*)/  444f4ytTtDKText7vDText24vDText40/$$If!vh#v#v#v#v #v#v#v :V 4*),5555 555 /  /  / /  / / /  /  444f4ytu\T$$If!vh#v#v#v #v#v:V 4*)555 55/  /  444f4ytx"TtDCText8$$If!vh#v#vh'#v :V 4*),55h'5 /  / /  444f4ytu\T$$If!vh#v#vr(:V 4*)55r(/  /  444f4ytx"TvDText29vDText26vDText27vDText28/$$If!v h#v#v=#v#v#v#v#v #v#v :V 4*), 55=55555 55  /  / / / / /   444f4ytu\T$$If!vh#v#v+#v #v#v#v :V 4*)55+5 555 /  /  444f4ytx"TtDeCheck1tDeCheck2$$If!vh#v#v #v#v#v:V 4*),55 555/  /  /  444f4ytx"T~$$If!vh#v)):V 4)),5))/  444af4yt {T$$If!vh#v#v(:V 4 )),55(/  /  /  444af4ytUTvDText30$$If!vh#v#v#v#v% #v:V 4)),5555% 5/  / /  444af4yt {TvDText31$$If!vh#v#v#v#v% #v:V 4)),5555% 5/  / /  444af4yt {TvDText32$$If!vh#v#v#v#v% #v:V 4)),5555% 5/  / /  444af4yt {TvDText33$$If!vh#v#v#v#v% #v:V 4)),5555% 5/  / /  444af4yt {TtD!Text1$$If!vh#v#v #v#v#v :V 4)),55 555 /  / /  444af4yt {TvDText34$$If!vh#v#v#v#v% #v:V 4)),5555% 5/  / /  444af4yt {TtD!Text2$$If!vh#v#v #v #v#v :V 4)),55 5 55 /  / /  444af4yt {TvDText35$$If!vh#v #v#v#v% #v:V 4P)),5 555% 5/  / /  444af4yt {T$$If!vh#vu(#v:V 4m)),5u(5/  /  444af4yt {T$$If!vh#v#v`'#v:V 4)),55`'5/  /  /  444af4yt {T$$If!vh#v(:V 40    ,5(9/  44 f4yt {T$$If!vh#v#v`'#v:V 460    ,55`'59/ / / /  / 44 f4yt {T5$$If!vh#v#vH#v8#v#v #v:V 40    ,55H5855 59/ / / /  / / 44 f4ytqhXTvDText36vDText12vDText16vDText205$$If!vh#v#vH#v8#v#v #v:V 40    ,55H5855 59/ / / / /  / 44 f4ytqhXTvDText37vDText13vDText17vDText215$$If!vh#v#vH#v8#v#v #v:V 40    ,55H5855 59/ / / / /  / 44 f4ytqhXTvDText38vDText14vDText18vDText225$$If!vh#v#vH#v8#v#v #v:V 40    ,55H5855 59/ / / / /  / 44 f4ytqhXTvDText39vDText15vDText19vDText235$$If!vh#v#vH#v8#v#v #v:V 40    ,55H5855 59/ / / / /  / 44 f4ytqhXT5$$If!vh#v#vH#v8#v#v #v:V 40    ,55H5855 59/ / / /  / /  44 f4ytqhXTx2 0@P`p2( 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p8XV~ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@66666_HmH nH sH tH @`@ NormalCJ_HaJmH sH tH JJ  Heading 1$$7$8$@&H$a$5\L@L  Heading 2$ p7$8$@&H$5\T@T  Heading 3$ 87$8$@&H$5CJ\aJR@R  Heading 4$$7$8$@&H$a$5CJ\aJJ@J  Heading 5$ @&5CJ\aJ>>  Heading 6$@& 6CJ]DA D Default Paragraph FontVi@V  Table Normal :V 44 la (k (No List \C\ Body Text Indent$7$8$H$`a$CJaJ44 Header  !4 4 Footer  !H"H  Balloon TextCJOJQJ^JaJj3j YHm Table Grid7:V06U`A6 2( Hyperlink >*B*phFVQF qhXFollowedHyperlink >*B*phOrPK![Content_Types].xmlN0EH-J@%ǎǢ|ș$زULTB l,3;rØJB+$G]7O٭Vj\{cp/IDg6wZ0s=Dĵw %;r,qlEآyDQ"Q,=c8B,!gxMD&铁M./SAe^QשF½|SˌDإbj|E7C<bʼNpr8fnߧFrI.{1fVԅ$21(t}kJV1/ ÚQL×07#]fVIhcMZ6/Hߏ bW`Gv Ts'BCt!LQ#JxݴyJ] C:= ċ(tRQ;^e1/-/A_Y)^6(p[_&N}njzb\->;nVb*.7p]M|MMM# ud9c47=iV7̪~㦓ødfÕ 5j z'^9J{rJЃ3Ax| FU9…i3Q/B)LʾRPx)04N O'> agYeHj*kblC=hPW!alfpX OAXl:XVZbr Zy4Sw3?WӊhPxzSq]y N   $  \:]]z^_0bc "$'*,468;=A" {hX~D[\]<]]2^^*_2_:_c  !#%&()+23579:<>?@O[av 3C4@Fiu{!>JPp|     " ( * 6 < > J P U a g i u { } N XFFFFFFFFG$G$FFFFFFFFFFFFFFFFFFFFFFFF8@0(  B S  ?$ _Hlt32821667 _Hlt32821668Text7Text24Text40Text8Text29Text26Text27Text28Check1Check2Text30Text31Text32Text33Text1Text34Text2Text35Text36Text12Text16Text20Text37Text13Text17Text21Text38Text14Text18Text22Text39Text15Text19Text23Pw4 5j?q   + ? V j ~ O @@  !"#bDG|"Q  ) = Q h | O %.O  $-44O =*urn:schemas-microsoft-com:office:smarttags PlaceName9*urn:schemas-microsoft-com:office:smarttagsplace=*urn:schemas-microsoft-com:office:smarttags PlaceType @ B C E F H I K O @ O 3s:NOOdeddee{{Y" _ c c   m m n p   - ? @ B C C E F H I K O " _ c c     - ? @ @ B C C E F H I K O  &>) _J:&B^`o(. ^`hH. pLp^p`LhH. @ @ ^@ `hH. ^`hH. L^`LhH. ^`hH. ^`hH. PLP^P`LhH.h^`.h^`.hpLp^p`L.h@ @ ^@ `.h^`.hL^`L.h^`.h^`.hPLP^P`L. _J:                   SRnF ]x":'2($-d1(4y5HG8):!;>rAB'EAE{KjMqhXbZN`["]'^cebihZiYHm,gmNs~tOwxVxUKz {=Q [LUU`bYoLar<<)NFZYj0iU5 muN.;qa1] dkN<[u\ERhuEo/ QZ@ B @ ddN @ @(@ZUnknownG.[x Times New Roman5Symbol3. .Cx Arial5. .[`)TahomaC.,*{$ Calibri Light7.*{$ CalibriA$BCambria Math"h3'3',b g F F 24: :  3QHP ?HG8"*!xxL (THE UNIVERSITY OF LOUISIANA at LAFAYETTEgobell Joell C Faulk  Oh+'0 ( H T ` lx,THE UNIVERSITY OF LOUISIANA at LAFAYETTEgobellNormalJoell C Faulk2Microsoft Office Word@vA@۩@@F  ՜.+,D՜.+,` hp  UL 鶹ýapp:  )THE UNIVERSITY OF LOUISIANA at LAFAYETTE Title 8@ _PID_HLINKSAnb'http://gradschool.louisiana.edu/?q=fif  !"#$%&'()*+,-./0123456789:;<=>?@ABDEFGHIJKLMNOPQRSTUVWYZ[\]^_`abcdefghijklmnopqstuvwxy{|}~Root Entry FP*Data C(1TableX2WordDocument8SummaryInformation(rDocumentSummaryInformation8zCompObjr  F Microsoft Word 97-2003 Document MSWordDocWord.Document.89q