International Student Application for Financial Assistance

This application is for international (non-US) students applying for financial aid at Le Moyne College. When completing this application, please be sure to convert all currency to US dollars (USD).

Student's Information

Legal First Name (Given)

Middle Name

Last Name (Family/Surname)

Email Address

Phone

Mailing Address

Country

Street

City

Region

Postal Code

Birthdate

Country of Birth

When do you expect to begin your studies?

Will you be:

Attending college/university

Transferring from another college/university for the first time

A returning student

Marital Status

Do you have legal dependents (not including your spouse/partner)?

Yes

How many legal dependents do you have?

Student's Citizenship

Country where you live

Primary Citizenship

Secondary Citizenship (if applicable)

Are you a Permanent Resident?

Are you a refugee or currently displaced student?

Please describe your current situation:

Family Information

On this application, “parents” means the custodial parent(s)—the parent or parents (or legal guardian) with whom the student lives. If the student’s biological or adoptive parents are divorced or separated, the custodial parent(s) are the parent or parents with whom the student has lived the most during the 12 months prior to filling the application. If the custodial parent has remarried, “parents” includes the student’s biological/adoptive parent and stepparent.

What is your parents'/legal guardians' current marital status?

Parent/Legal Guardian 1

Parent/Guardian 1 Last Name

Parent/Guardian 1 First Name

Parent/Guardian 1 Relationship

Parent/Guardian 1 Age

Parent/Guardian 1 Address

Country

Street

City

Region

Postal Code

Parent/Guardian 1 Employment Status

Parent/Guardian 1 Occupation Title

Parent/Guardian 1 Employer

Parent/Guardian 1 Number of Years with Employer

Parent/Legal Guardian 2

Parent/Guardian 2 Last Name

Parent/Guardian 2 First Name

Parent/Guardian 2 Relationship

Parent/Guardian 2 Age

Parent/Guardian 2 Address

Country

Street

City

Region

Postal Code

Parent/Guardian 2 Employment Status

Parent/Guardian 2 Occupation Title

Parent/Guardian 2 Employer

Parent/Guardian 2 Number of Years with Employer

Brief Explanation of parents'/legal guardians' work:

How many people (including yourself) depend on income of your parents/legal guardians for daily living expenses?

Use the space below to explain any unusual expenses, other debts, or special circumstances that we should consider when deciding how much financial aid, if any, you will receive.

Special Circumstances

Please specify any barriers or challenges you face in providing supplementary documentation to demonstrate income values, banking records, business values, etc.

Additional Information

Select any circumstances with ongoing financial impact that apply to your family

College/Program Information

Housing Plan

On Campus

Living with Family

Undecided

Admission Plan

Early Action

Regular Decision

Income

What documentation will you be providing to verify income and asset information requested on this form? (Check all that apply)

Other

What is the official exchange rate of your country's currency to the US $ today? (For example, 3,100 pesos = US $ 1)

(Please use this exchange rate for all calculations on this form)

Does your government currently impose restrictions on the exchange and release of funds for study in the United States?

Yes

Describe the restrictions

Do you have a source of emergency funds once you arrive in the United States?

Yes

Source

Amount available in US $

Do you have a source of funding to cover your air transportation to the United States?

Yes

Maybe

Source (e.g., parents' income, sponsor, etc.)

During 2022, how much of your household income (before taxes or expenses) came from the following sources (in US $)?

Parent/Legal Guardian 1 work

Parent/Legal Guardian 2 work

Your work

Your spouse's work

Family business

Rent from family real estate holdings

Pension/annuity/ retirement

Other adult members of household

Interest or dividends

Housing, food, other living allowances

Assistance from government or international agency (UNHCR, FAO, etc.)

Family pension

Other

If other, please explain:

Does Parent/Legal Guardian 1 have a retirement/pension account?

Yes

If No, does the government provide funding upon retirement?

Yes

Does Parent/Legal Guardian 2 have a retirement/pension account?

Yes

If No, does the government provide funding upon retirement?

Yes

Will there be a significant increase or decrease in your family’s income next year?

Yes

If yes, explain:

Property and Assets

Please submit documentation to verify the information on this form. Property and assets information pertains to the parents/legal guardians, or to the student and the student’s family if the student is married and lives independently of the parents/legal guardians. Write in the value of property and assets and, where asked, any debt against the asset as of the time you complete this application.

Do your parents/legal guardians have a bank account?

Yes

Does your parents/legal guardians own their home?

Yes

What year was it purchased or built?

What was the original purchase price or cost to build?

How much does your family still owe on the purchase price?

What is the present market value (if known)?

If your home was not purchased/built, how was it obtained?

Does your family own a business?

Yes

Date business commenced

Your parents' share of business value

Type of business

Your parents' share of business indebtedness

Instructions: Please list the value of the following family assets in US Dollars (if applicable)

Land and buildings (other than home or business)

Indebtedness on land and buildings

Savings

Investments (such as stocks and bonds)

Assets owned by students (in excess of US $100)

Money owed to family by others

Repayment (of money owed by others) to be expected this year

Other (jewelry, artwork, antiques, etc.)

Do you or your family have money, property, or assets in another country (other than the student’s country of residence)?

Yes

Which? (Check all that apply)

Money

Property

Assets

Money

Money US $ Value

In which country(ies)?

Asset Owner

Property

Property US $ Value

In which country(ies)?

Asset owner

Assets

Assets US $ Value

In which country(ies)?

Asset owner

Do you or your family own (an) automobile(s)?

Yes

Make (ex. Fiat, Ford, Toyota, etc.)

Year of manufacture

Expenses

How much did your family spend on the following expenses during 2023? Specific amounts are needed. (Write in the annual amount in US dollars your family spent on the items listed. If you do not know the actual
amount, please estimate.)

Rent or mortgage: US $

Utilities US $

Food US $

Clothing US $

Household necessities US $

Standard Annual Care Medical expenses US $

Educational expenses US $

Loan payments US $

Taxes US $

Public Transportation expenses US $

Care for relatives US $

Amount allocated to savings/retirement US $

Automobile maintenance US $

Insurance (health and property) US $

Entertainment/Vacation US $

Household Staff US $

Other US $

If Other, please explain

How much money does your family owe to other people or to financial institutions? US $

Amount paid on debt in 2023 US $

Reason for debt

Does your family employ other people?

Yes

How many in the home?

How many in the family business?

Sources of Financial Support

Enter the expected amount of anticipated annual support toward your educational costs from the sources
listed below (in US $):

Student's earnings/assets

2024-2025

2025-2026

2026-2027

2027-2028

Family's earnings/assets

2024-2025

2025-2026

2026-2027

2027-2028

Other sources of outside funding

2024-2025

2025-2026

2026-2027

2027-2028

Additional Information

If there is any additional information about your financial situation not already captured in this form that would be helpful to assess your financial need, please add it here.

Additional Information

Signature

We declare that the information on this form is true, correct, and complete. The college/university has our permission to verify the information reported by obtaining documentation as needed. WARNING: Providing false information may jeopardize a student’s visa status and furthermore may result in a college/university revoking its initial decision to enroll the student.

Student's Signature

Parent/Legal Guardian 1's Signature

Parent/Legal Guardian 2's Signature (if applicable)