KENTUCKY STATE UNIVERSITY Declaration & Certification of Finances (For International Students Only)

A Certificate of Eligibility (form I-20 or DSP-66) will not be authorized until this form is completed and returned. When all admissions criteria have been appropriately met for Graduate Studies, a copy of this form will be attached to the Certificate of Eligibility. Both must be shown to the U.S. Consulate for issuance of the Visa.

*ESTIMATED GENERAL EXPENSES FOR THE GRADUATE STUDENT * 2009-2010 ACADEMIC YEAR (FALL AND SPRING SEMESTERS)

Tuition @811 per credit hour x 9 credit hours or Full-Time811 x 9 x 2(semesters)14,598 per year
Books and Supplies1,200 per year
Personal Expenses 3,500 deposit +2,000 for 2 semesters5,500 per year
Miscellaneous (Includes Transportation)1,310 per year
TOTAL COST PER ACADEMIC YEAR19,108
*Travel Cost Will Vary

A confirmation deposit of $3,500 (US) is sent to the Office of Graduate Admissions. A student may use a maximum of 65% of the $3,500 deposit to pay the first semester's tuition and fees. The balance will remain on account until the student graduates or withdraws from Kentucky State University.

**ALL FEES SUBJECT TO CHANGE WITHOUT NOTICE**

Family NameFirst NameMiddle Name
Complete Street Address
Complete Street Address (cont'd)
CityProvinceCountryZip Code
MajorDate of Expected Graduation
Birth DateCountry of Birth
Intended enrollment at KSUFallSpringSummerYear

OFFICIAL VERIFICATION OF SOURCES OF FUNDS AND AMOUNTS

First Year Source of Funds (U.S. Dollars Only)

  • $3,500 initial deposit $
  • Student’s Personal Funds $
  • Funds from Family $
  • Funds from another source (please specify) $

TOTAL

$_____