North Hennepin Community College
International Students (F-1 Visa Applicants Only)
Application for Admission
North Hennepin Community College is a member of Minnesota State Colleges and Universities and an equal opportunity employer and educator. This document is made available in alternative formats to individuals with
disabilities by calling 763-493-0555 or through the Minnesota Relay Service at 1-800-627-3529. North Hennepin Community College’s Access Services office can be reached at 763-493-0555.
09/08/20 CB
Financial Certificate
International applicants must provide evidence of financial support to pay for one full year of total
expenses, including tuition/fees, books, supplies, medical insurance, and living expenses. Admission to
NHCC will not be granted
until this form is completed, per United States government regulations.
Tuition/Fees ($210/credit x 24 credits)
$ 5,040
Books and Supplies (estimated)
$ 1,000
Medical Insurance (per year - required)
$
2,119
Living Expenses (estimated)
$14,000
TOTAL*
$
22,159
*
* Students with dependents must add $3,500 for a spouse and/or $2,500 for each child.
Applicant’s Name:
Source of Funds:
Check (X) all that apply below
Required Supporting Documentation List Sponsorship
Amount (in USD)
Sponsor Name
Relationship
Original Bank
Statement from sponsor
$
Self-Sponsor (Applicant)
Original Bank
Statement from student
$
Government Sponsorship
Signed Award Letter
$
Scholarship
Signed Award Letter
$
TOTAL FUNDS
Total Must Equal At Least
$2
2,159
$
I have reviewed information provided by the applicant named on this form and funds are available to support their education.
Sponsor’s Name (print)
Sponsor’s Signature
Date
Signature of Notary*
Notary Seal
Notary Commission Expiration
*Sponsor and Notary signature is required in order to this form to be considered valid, unless notary service
is not available in country of origin and stamp/seal is on bank statement instead. Form must be submitted in
person or by postal mail with the sponsor’s original signature and the original notary signature and stamp.
