Financial Certification Form 

Section 1: My Program Information 

1a.  My academic school, program, and degree:   _________________       _______________________________  School, e.g. Business         Program, e.g. Real Estate Development   

______________ Degree, e.g. MBA 

 1b.   My total expenses for the first academic year of my program as listed here: http://bit.ly/estexpense $____________________________        (if you’re coming for one semester only, put half of the total expenses)   

1c.   My dependent(s)’ total expenses for the first academic year of my program                                          $____________________________ 

    1d.   My First Academic Year’s Total Expenses                                                                                                  $____________________________   

Section 2: My Funding Sources (for My First Academic Year) Descriptions of the types of documents you need to submit to us (along with this form) are included in this checklist: http://bit.ly/funddocs  

 Source A.  My Personal Funds                                                                                                                            $____________________________ 

 Source B.  My Parents, Family, and/or Friend’s Funds     ______________________________       ________________________________________              $____________________________                Sponsor #1’s full name                              Relationship - Parent, Sibling, Friend, etc.     ______________________________       ________________________________________              $____________________________               Sponsor #2’s full name                              Relationship - Parent, Sibling, Friend, etc.     ______________________________       ________________________________________              $____________________________               Sponsor #3’s full name                              Relationship - Parent, Sibling, Friend, etc.     Do you have another sponsor?   Source C.  My Approved Awards, Grants, or Scholarships                                                                               $____________________________   Source D.  My Approved Student Loans                                                                                                            $____________________________    Source E.  My Employer’s Sponsorship                                                                                                              $____________________________         Total Funding for My First Academic Year                                                                                                      $____________________________    

ISSO Morningside   |  ISSO-CUMC  |   http://bit.ly/applyCOE 

Section 3: Acknowledgement 

Student Acknowledgement  I, _______________________  certify that the funding sources listed in Section 2 will pay for my first academic year’s tuition, fees, and living expenses.                    Student’s full name 

    I plan to complete my program in one academic year (two semesters) or less. Do not complete Section 4 on the next page. 

➡ __________________________________                         Student’s Ink Signature   

________________ Date, MM/DD/YYYY 

 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -  Sponsor #1 Acknowledgement  

 I, ______________________   will provide the amount listed in Section 2, Source B for      1       2       3 or more  year(s) of the academic program.               Sponsor#1’s full name                                                                                                             Check one                                                                                                                          ➡ __________________________________     ________________                                                                                                                                        Source B Sponsor #1’s ink signature                  Date, MM/DD/YYYY   Current Address     ___________________________________________________________________________________________________________                                  Building number               Street                                                                                             Apartment number  _______________________     ______________________________          ___________________________         _______________________________                     City                                                      Province                                                        Postal Code                                            Country   Email ________________________________________________________________         Telephone ________________________________________    - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -  Sponsor #2 Acknowledgement  

 I, ______________________   will provide the amount listed in Section 2, Source B for      1       2       3 or more  year(s) of the academic program.               Sponsor#2’s full name                                                                                                            Check one                                                                                                                           ➡ __________________________________     ________________                                                                                                                                        Source B Sponsor #2’s ink signature                   Date, MM/DD/YYYY   Current Address     ___________________________________________________________________________________________________________                                  Building number               Street                                                                                             Apartment number  _______________________     ______________________________          ___________________________         _______________________________                     City                                                      Province                                                        Postal Code                                            Country   Email ________________________________________________________________         Telephone ________________________________________  - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -  Sponsor #3 Acknowledgement  

 I, ______________________   will provide the amount listed in Section 2, Source B for      1       2       3 or more  year(s) of the academic program.               Sponsor#3’s full name                                                                                                            Check one                                                                                                                          ➡ __________________________________     ________________                                                                                                                                        Source B Sponsor #3’s ink signature                 Date, MM/DD/YYYY   Current Address     ___________________________________________________________________________________________________________                                  Building number               Street                                                                                             Apartment number  _______________________     ______________________________          ___________________________         _______________________________                     City                                                      Province                                                        Postal Code                                            Country  Email ________________________________________________________________         Telephone ________________________________________ 

ISSO Morningside   |  ISSO-CUMC  |   http://bit.ly/applyCOE 2 

Section 4: My Funding Sources (My Funding Sources for Future Academic Years) ● Do I need to complete this section? If your program is longer than one academic year (or longer than two semesters).  ● Why do I need to complete this? For multi-year programs you need to have reliable financial resources for the length of the program.   ● How do I complete this? Use your school’s estimated expenses (as listed on http://bit.ly/estexpense) to complete the information below. You do not need to document these 

resources at this time. 

 Source A.  My Personal Funds                                                                                                                            $____________________________ 

Source B.  My Parents, Family, and/or Friend’s Funds     ______________________________       ________________________________________              $____________________________                Sponsor #1’s full name                              Relationship - Parent, Sibling, Friend, etc.     ______________________________       ________________________________________              $____________________________               Sponsor #2’s full name                              Relationship - Parent, Sibling, Friend, etc.     ______________________________       ________________________________________              $____________________________               Sponsor #3’s full name                              Relationship - Parent, Sibling, Friend, etc.     Do you have another sponsor?   Source C.  My Approved Awards, Grants, or Scholarships                                                                               $____________________________   Source D.  My Approved Student Loans                                                                                                            $____________________________    Source E.  My Employer’s Sponsorship                                                                                                              $____________________________          Total Funding for each of my future Academic Years                                                                                    $____________________________  

        

I, __________________________________ certify that the funding sources listed above will pay for my future academic years’ tuition, fees, and living expenses.                  Student’s full name 

                                                                                         ➡ __________________________________     ________________                                                                                                                                                                                          Student’s Ink Signature                             Date, MM/DD/YYYY 

 

Section 5: Student Financial Services 

Thank you for submitting your application for a COE to the ISSO. The information you are listing and documenting also may be provided to other university offices upon their request, such as your school's Financial Aid office or Student Financial Services (SFS).  SFS is the university office that provides information and methods for paying your bill. Please review their important information on the following topics:   

● Single Prepayment Plan:  http://bit.ly/singleprepay ● Columbia Institutional Loans and Disclosures: http://bit.ly/instloans ● Private Loans:  http://bit.ly/privloans 

 If you have questions or require additional information, please contact SFS directly: http://sfs.columbia.edu/ 

ISSO Morningside   |  ISSO-CUMC  |   http://bit.ly/applyCOE 3