Note: If you are supporting yourself, this form is not necessary. Submit your own original bank statement only.
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Name of Sponsor ____________________________________ Address _________________________________________________ |
Occupation _________________________ Telephone __________________________ |
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for the amounts listed below. |
In the spaces provided below, write the amount (in US dollars) for each semester for which you will provide financial support. Please note that the minimum amount is US $8,650 for 2 semesters or US $4,325 for 1 semester. If the student has dependents, an additional $700 per semester per dependent must also be shown.
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$____________ |
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$____________ |
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$____________ |
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$____________ |
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$____________ |
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$____________ |
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__________________________________________________ |
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____________________________________ |
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___________________ |
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Signature of Sponsor |
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Relationship to Student |
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Date |
Please attach an original bank statement from sponsor to verify that the
minimum amount required is available for each semester(s) marked above.
Sponsors who live in the United States must provide an original bank statement
that can be sent to the student.
Note: Sponsors who contribute at least 50% of a student's support will be informed
of the student's progress.
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Return to: |
Dr. Glen. W. Probst, English Language
Center, 4056 JFSB, Brigham Young University, Provo, UT 84602 |
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