AFFIDAVIT OF SUPPORT

Directions: This form should be filled out by the person who will provide the applicant with financial support while he/she is in the United States.

NAME: _________________________________________________________

ADDRESS: ______________________________________________________

______________________________________________________

CITY/STATE OR PROVINCE: ______________________________________

COUNTRY: ________________TELEPHONE NO: _____________________

STUDENT’S RELATIONSHIP TO YOU: ______________________________

I am executing this affidavit on behalf of the following international student applicant to Los Angeles Harbor College:

NAME OF STUDENT: _____________________________________________

ADDRESS OF STUDENT: __________________________________________

__________________________________________

I am willing and able to provide financial support for this student while he/she is enrolled at Los Angeles Harbor College and will guarantee that such person will not become a public charge while in the United States and will depart prior to expiration of authorized stay in the United States.

I understand that school and living expenses for a student for an academic year are approximately $14,282, and that Los Angeles Harbor College does not offer medical services, financial aid or scholarships, and that no housing is available through the college. I am attaching a statement from a bank or other financial institution in which I have deposits.

_____________________________ __________________________

Signature Date

Residents of the United States (who must be citizens or permanent residents) may submit instead of bank statement, a statement from employer on business stationery showing salary paid, nature of employment and length of employment; if self-employed, a copy of last income tax return file is required.