Request for Certificate of Eligibility (I-20) for Study at Armstrong Atlantic State University

Please check which of the following apply:  [  ] Initial entry into the United States from a foreign country to study under a student (F-1) visa.  [  ] Continuation of study after attending another institution in the United States under a Certificate of Eligibility issued by that institution.  1. Name_________________________________________________________    last (family)firstmiddle  2. Social Security Number____________________________________________   3. Date of Birth____________________________________________________  monthdayyear  4. Place of Birth___________________________________________________    citycountry  5. Country of Nationality (citizenship) __________________________________  6. Major Field of Intended Study (history, nursing, etc. Required by INS) _______  _______________________________________________________________  7. Degree Objective[  ] Associate Degree[  ] Bachelors Degree[  ] Masters Degree  8. Semester of Application ___________________________________________  I understand that a Certificate of Eligibility will be issued to me if I am accepted to Armstrong Atlantic State University and meet other requirements as stated by Armstrong Atlantic State University and the Immigration and Naturalization Service regarding issuance of the certificate.  I have already submitted, or am currently submitting, the required financial statement to Armstrong Atlantic State University.  I understand that the use of the Certificate of Eligibility is for study at Armstrong Atlantic State University only and may not be used to enter the United States for study at any other institution.  _____________________________________________________________  SignatureDate  Armstrong Atlantic State University is an affirmative action/equal opportunity education institution and does not discriminate on the basis of sex, race, age, religion, handicap, or national origin in employment, admissions, or activities.

 
Financial responsibilities
Listed below are the minimal costs for attending Armstrong Atlantic State University as a full-time student for the 2000 -2001 academic year (August- May).  You are required to have  the funds on account at the time  of your initial registration to defray your educational expenses for one academic year.*
Undergraduate
2000-2001 Annual Expenses (2 Semesters)

Tuition	7458.00
Books	567.00
Room/Board	4413.00
Transportation	309.00
Medical	309.00
Personal Expenses	1545.00
Total on Deposit	14,601.00 U.S. Dollars

* Married students should have on account an additional $4,000.00
Please note that these expenses are an approximation.  While your personal expenses may vary, Armstrong Atlantic State University requires proof of finances equaling $14,601.00 U.S. Dollars.
CAUTION:Read and understand this form before filling it out.  Every question must be answered.  The form must be signed and notarized or it will be returned to you for completion.  If additional space is required, attach an extra page.
1. Are you head of your family?[  ]Yes[  ] No
2. List all persons financially dependent on you:
 

Name of Person	Age	Relationship	Will this person:  1. Remain in home country   2. Accompany you to the U.S.   3. Join you later
.	.	.	.
.	.	.	.
.	.	.	.
.	.	.	.

3. Does your government restrict the exchange or release of funds available to you once you are in the U.S.?
[  ] Yes[  ] No
If yes, what are the restrictions?_____________________________________________________
______________________________________________________________________________
4. Indicate the annual amount of support (U.S. Dollars) from all sources________________________
Support must be for the duration of the intended program of study
Sources of SupportAmounts (in U.S. Dollars)

	First Year	Second Year	Third year	Fourth Year
Personal*	.	.	.	.
Parents/Guardians*	.	.	.	.
Friends residing in U.S.**	.	.	.	.
Government***	.	.	.	.
Business Organizations***	.	.	.	.
Employer***	.	.	.	.
Other Sponsor***  Specify____________________	.	.	.	.
Total	.	.	.	..

IMPORTANT:  These amounts must have proof of availability attached.

*	Must be documented by notarized letter(s) stating willingness, reason, amount, duration and ability (statements from banks and/or employers).
**	Must be supported by Affidavit of Support
***	Must be supported by a notarized letter indicating amount, duration and reason.

Statement of Understanding
A Certificate of Eligibility is not issued until this document is properly completed, returned to Armstrong Atlantic State University with all supporting attachments and made a part of your permanent record.  The Certificate of Eligibility will be issued only for the purpose of obtaining a student visa or reentry into the United States to study at Armstrong Atlantic State University.
Any omissions, misrepresentations of facts or failure to furnish information automatically invalidates acceptance of the applicant into the university and results in termination of the Certificate of Eligibility.
When issuing a Form I-20 for transfer from another U.S. Institution, Armstrong Atlantic State University must certify to the U.S. Immigration and Naturalization Service (INS) that you have sufficient funds to finance your total expenses while pursuing the degree for which you are applying.
The U.S. Immigration and naturalization Service does not grant work permits to students on F-1 visas during the first year of enrollment.  During the second year and thereafter, the Director of Admissions may certify that you are eligible to apply for a work permit granting you permission to work a maximum of 20 hours per week through INS under the following circumstance: you have experienced an unforeseen change in your financial circumstances and you are in good academic standing.
Under certain circumstances, you may be required to deposit, in advance, an equal amount to the first year's tuition and fees.
I certify that I have read the information on this document and the information I have provided on the sources and amounts of funds is true, correct and complete.  Properly executed supporting documents are attached.  Further, I will notify Armstrong Atlantic State University of any change in my financial situation.
Signature of Applicant ____________________________________
Printed Name of Applicant _________________________________
Subscribed and sworn before me this _______ day of  20___.
____________________________________
Signature of Judge, State Official or Notary Public
____________________________________
Date Term Expires

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