University of Maine at Presque Isle

Affidavit of Support ~Canadian Students Only

Office of Admissions~181 Main Street, Presque Isle ME 04769

Please complete this form and attach it to your financial documentation.
Fax it to (207) 768-9777 or you can mail it to the address above.

Thank you for applying to UMPI! As an international applicant the federal SEVIS regulations require international students to
demonstrate that they have current resources to support themselves during their first year of study in the U.S. In order for the
University of Maine at Presque Isle to provide you with visa sponsorship, you must submit evidence that you have funding available
to meet the total expenses outlined on page two. Please read all sections carefully. Neatly print in black ink or type the
information requested and include all required documentation. You will be required to show proof of financial support at the
border when applying for your student visa. Therefore, be sure to maintain an official copy of financials for this purpose.

Section A: STUDENT INFORMATION

Name (as it appears on Passport): __________________________________________Date of Birth: ______/_____/______

Month Day Year
Address to mail your Student Visa I-20 document:

____________________________________________________________________________________________________________

____________________________________________________________________________________________________________

City: _______________________________________ Province: ____________________ Postal Code: _______________________

Telephone: _____________________________________ Email: ______________________________________________________

Country of Birth: ______________________ Country of Citizenship: __________________________________________________

Degree sought: ❑Teacher Certification ❑Bachelor’s ❑Associate’s

In the field of: _______________________________________________________________________________________________

Living Arrangements:

 I plan to commute from Canada

 I plan to live on campus in a residence hall
 I plan to live off campus

Section B: RESIDENCE INFORMATION

 I am a documented Dual Citizen of Canada and the United States

 I am a documented Native American
I have a current U.S. Visa or Permanent Resident card (please send photocopy)

If you did not check off anything in Section B, please continue to Section C.

Section C: SEVIS INFORMATION

Do you have a SEVIS I-20 form from another school? Yes___No___If yes, what is your SEVIS number? N__________________
Are you currently in status? Yes___No___If yes, what is the date you will complete your program?_________________________
If you are transferring from a college or high school in the U.S., please provide the name, address, and phone number of the school:
_________________________________________________________________________________________________________

_________________________________________________________________________________________________________
SECTION D: FINANCIAL DOCUMENTS

Proof of funds usually include, bank statements, mutual fund statements, scholarship letters or signatures on the lines below. You must also
provide a signature from your sponsor verifying the amount he or she is willing to provide on your behalf. All documentation should be in
U.S. funds and less than 12 months old. All materials received will be kept confidential. Please remember to keep a copy for your records.

U.S. $_____________Student’s personal funds.

Please circle the source of funding: Bank Account, Financial Loan, Line of Credit.

____________________________________________________________________
Bank or Financial Official’s Signature Date

____________________________________________________________________
Bank or Financial Official’s Title Name of Bank or Financial Institution

U.S. $_____________Funds from Parent(s), Relative(s) or Sponsor(s).

Please circle the source of funding: Bank Account, Financial Loan, or Line of Credit.

____________________________________________________________________
Signature of Parent, Relative or Sponsor Date,

____________________________________________________________________
Bank or Financial Official’s Signature Date

____________________________________________________________________
Bank or Financial Official’s Title Name of Bank or Financial Institution

U.S. $____________ Funds from Canadian and Provincial Student Loans, Bursary
(If eligible, full benefits usually average between $10,000 -14,000 US funds. If you have received a loan previously,
this amount should be an indicator of what you might be eligible for in the future. Put your estimate in the blank
space to the left. No documentation is required if you have applied for these loans. Send this Affidavit of Support
form to the Admissions Office immediately. Forward your CSL award documents to the University when you
receive them.)

U.S. $_____________ Funds from Training & Development, Scholarships, etc. Please submit photocopy of award letter.

Total U.S. $___________________ (This Total amount must equal or exceed amount listed below.)

Canadian Students: Estimated Costs in U.S. Funds

Please keep in mind that the costs below are reflective of two semesters for the purposes of establishing financial documentation for a visa.
Teacher certification students usually stay for an abbreviated summer session and a semester of student teaching. These costs are not
included in the figures below. THIS IS NOT YOUR BILL

Teacher Certification Students Undergraduate Students

Tuition/Fees (36 credit hours= 2 semesters) $13,712 Tuition/Fees (30 credit hours= 2 semesters) $11,920
Room/Board or Housing Expenses $7,844 Room/Board or Housing Expenses $7,844
Books, Travel, Personal $2,500 Books, Travel, Personal $2,500
TOTAL $24,056 TOTAL $22,264

I will be responsible for the payment of all costs I incur at the University of Maine at Presque Isle. I
understand this is a document required by the US Government and is not meant to be an exact
accounting of the cost of my education.

_______________________________________________________________ _________________________________
Student’s Signature Date