DENISON
Certification of Finances
Instructions:
All applicants that are not eligible for federal student aid (non-US citizens or permanent residents) are required to submit this form
with their application for admission.
Please carefully review and complete the application below. We do not require any bank attestation or documentation with this form,
although we may request such documentation on a case-by-case basis. This form can be completed electronically, but it must be
reviewed and hand-signed by both the student and a parent or guardian. If a question is not applicable, please leave it blank. Report
all currency in U.S. dollars (USD).
Contact the Office of Admission at admission@denison.edu if you have any questions or need to make any changes after you submit
this form.
STUDENT INFORMATION
_________________________
_________________________
_________________________
Student’s First Name
Student’s Middle Name
Student’s Last Name
_________________________
_________________________
_________________________
Date of Birth (MM/DD/YYYY)
Country of Birth
Country of Citizenship
__________________________________________________________________________________________
Permanent Address (Street, City, Country)
__________________________________________________________________________________________
Mailing Address (Street, City, Country) — if different from permanent address
_________________________
Size of Household (total family members, including you)
PARENT/GUARDIAN 1 INFORMATION
_________________________
_________________________
_________________________
Parent/Guardian’s First Name
Parent/Guardian’s Middle Name
Parent/Guardian’s Last Name
_________________________
_________________________
_________________________
Date of Birth (MM/DD/YYYY)
Country of Birth
Country of Citizenship
_________________________
_________________________
_________________________
Occupation
Job Title
Annual Salary
__________________________________________________________________________________________
Permanent Address (Street, City, Country)
__________________________________________________________________________________________
Mailing Address (Street, City, Town/City, Country) — if different from permanent address
_________________________________________________________
OFFICE OF ADMISSION | DENISON UNIVERSITY | 740-587-6276
PARENT/GUARDIAN 2 INFORMATION
_________________________
_________________________
_________________________
Parent/Guardian’s First Name
Parent/Guardian’s Middle Name
Parent/Guardian’s Last Name
_________________________
_________________________
_________________________
Date of Birth (MM/DD/YYYY)
Country of Birth
Country of Citizenship
_________________________
_________________________
_________________________
Occupation
Job Title
Annual Salary
__________________________________________________________________________________________
Permanent Address (Street, City, Country)
__________________________________________________________________________________________
Mailing Address (Street, City, Town/City, Country) — if different from permanent address
EXPECTED FINANCIAL SUPPORT
In this table, please report what you are able to contribute each year toward the standard direct costs at Denison. Standard direct costs
are considered tuition, multiple occupancy housing, and “The Hill” meal plan on an annual basis. If you choose a housing or meal plan
that exceeds the cost of the standard option, you are responsible for the difference in costs. In addition, the standard direct costs do not
include other expenses, like books, transportation, health insurance, incidental expenses, or any other charges that you could accrue
throughout your program, depending on what optional offerings you choose to pursue. Report all currency in U.S. dollars (USD).
First Year
Second Year
Third Year
Student’s Sources
of Funds (Personal
and Parental)
Sponsor Funds*
Total
*If you are receiving funds from a sponsor, please explain below:
_________________________________________________________
OFFICE OF ADMISSION | DENISON UNIVERSITY | 740-587-6276
Fourth Year
ADDITIONAL INFORMATION
If you would like to share any additional information, please do so below:
I certify that the information provided on this form and all supporting documentation is true to the best of my knowledge. I understand
that additional documentation may be required to verify any information provided.
_______________________________________
________________________________________
Student Signature
Parent/Guardian Signature
Date
_________________________________________________________
OFFICE OF ADMISSION | DENISON UNIVERSITY | 740-587-6276
Date