Financial Disclosure form

FINANCIAL DISCLOSURE FORM
For international students applying for the 2024-25 academic year

ESTIMATE OF EXPENSES IN U.S. DOLLARS

Tuition and Fees $49,258

Health Insurance $1,369
Living Expenses (Food & Housing) $14,612
Nine-Month Total Expenses *$65,239

*If you are offered a merit scholarship, this amount will be reduced.

FINANCIAL GUARANTEE
Students must show proof that they have funding available to contribute a minimum of $30,000 toward their cost of attendance for the 2024-25 academic year.

Applicant Last Name/ Family Name

First Name

Students Email Address

Date of Birth

Parent /Sponsor Last/Family Name

Parent /Sponsor First Name

I guarantee that I will be responsible to assist with the below mentioned amount for the student named above for every year of their attendance at Lycoming College

Please enter the $USD amount that you are guaranteeing responsibility.

Parent/Sponsor Signature

FINANCIAL INSTITUTION (BANK NAME)

Please upload a copy of a bank statement showing the information provided by the applicant on the form and that the funds described are readily available. Please include an authorized bank officials signature.

Terms of Agreement

By selecting the “I agree” button, I am signing this document electronically. I agree that my electronic signature is the legal equivalent of my manual/handwritten signature on this document.

By selecting “I agree” using any device, means, or action, I consent to the legally binding terms and conditions of this document. I further agree that my signature on this document is as valid as if I signed the document in writing. I am also confirming that I am authorized to enter into this Agreement. If I am signing this document on behalf of a minor, I represent and warrant that I am the minor’s parent or legal guardian.