International House Financial Aid Student Budget (Part 2 of 4) Spring Semester 2017 (NOTE: Read all instructions prior to submission) MAC users: Do NOT use Viewer to submit Instead, save to your computer hard drive, rename with your last name and then submit The deadline for all submissions is November 10, 2016 Your Name: Last: First: Middle: Application Instructions Applications for partial room and board financial aid are available to graduate or upper division registered international students, US citizens and permanent residents who have demonstrated financial need and meet all other qualifications Applicants must be an upper division or graduate student, be registered in a degree-seeking academic program at UC Berkeley and have a confirmed I-House Room Contract for Spring 2017 to be eligible to apply for IH Financial aid The purpose of the financial aid program is to offer UC Berkeley students who demonstrate financial need an opportunity to experience firsthand, cultures from all over the world while enabling international students to learn about the ethnic and economic diversity in the United States If you are interested in applying for financial assistance, please complete the Financial Aid Registration (Step One) using the online form, available at http://ihouseberkeleyedu AND complete and return this Student Budget Form sent as an email attachment Also send your personal statement/essay as one Word doc, & unofficial transcript or last completed grades If you are US resident, your FAFSA report also needs to be submitted by email SUMMARY OF FINANCIAL AID APPLICATION STEPS 1 Complete and submit the on-line Financial Aid Registration Form (Step One) (Click link at http://ihouseberkeleyedu/applicants/aidinstructionsphp); 2 Download & save to your computer this completed I-House Student Budget Form, titled with your last name; Email it as an attachment to the appropriate email address found on page 5 3 Email as attachments: Completed required Essay and Summary statement in one Word Doc only (No PDFs); Unofficial transcript that shows your most recently completed coursework/grades; 4 FAFSA Report (US citizens & permanent residents only) NOTE: The FAFSA process takes 3 days to complete Please request your FAFSA Student Aid Report (SAR) early, as it must be included with your application materials Essay Instructions (see last page) Student Financial Aid Budget Form: NOTE: Every question must be answered in order to be considered for partial room and board support Additionally, only forms & documents that are submitted electronically and titled with the last name of the applicant will be accepted
IV PERSONAL RESOURCES Total funds deposited in all bank and market accounts in the US and abroad: How much of the above can you spend for school for the Spring Semester and why? * Information may be verified Please state other personal income: * TOTAL PERSONAL RESOURCES (Add starred items only) V FAMILY/RELATIVES/SPONSOR RESOURCES Are you the main provider? Yes No If yes, go to Section VI If no, please answer all questions in Section V Name of main provider of funds Occupation Relationship Annual Family Income Total family funds in all bank and market accounts in US and abroad: Annual income from assets such as: property, stock, business interest, etc Number of children supported by family income Amount of support you received last year: Please indicate support you EXPECT to receive from your family, relatives or sponsors during the semester: Name of relative who provides support Occupation Amount of Support Name of relative who provides support Occupation Amount of Suppor Name of relative who provides support Occupation Amount of Support Name of sponsor that provides financial or Address Amount of Support other support TOTAL EXPECTED FAMILY/RELATIVES/SPONSOR RESOURCES Page 2 of 5
VI INTERNAL/EXTERNAL RESOURCES The purpose of the financial aid program is to assist you to meet your financial and educational goals It is important to show all financial resources to help us determine your financial need for the Spring Semester Type and Number of Applied # Expected # Name Semester(s) Amount Expected to receive Scholarship(s) S Fellowship(s) S GSI S GSR S Department Grant S Nonresident Tuition Waiver S Fee Remission S On-Campus Work S Off-Campus Work S Loans S Other S Other S Total Loan Balance to date: New Loan for this year: PLEASE LIST ALL RESOURCES NOT LISTED ABOVE United States Government (agency & amount) Foreign Government (name and amount) Other organization/agency (name and amount) Any other source (describe nature, name, and amount): TOTAL INTERNAL/EXTERNAL RESOUCES Continued on next page Page 3 of 5
VII ESTIMATED STUDENT BUDGET Expense Category for Spring Semester Tuition and Fees Books and Supplies (650 maximum) Housing (I-House rate) Utilities (phone, etc) (4 max) Food (1,0 max) Travel (itemize; 1,5 max) * Describe * Transportation (local; 2 max) *Describe Medical/Dental (itemize) (Not covered by SHIP insurance; 2 max) Projected Expenses RESOURCES (carry over from previous pages) IV Your Personal Resources V Family/Relative/Sponsor Resources VI Internal/External Resources TOTAL RESOURCES ============================================== CURRENCY INFORMATION Amount of support received in foreign currency The current exchange rate between foreign currency and US dollar is 1 = Are there currency exchange restrictions on sending money out of your country? Yes No If yes, have you applied for an exchange permit? If no, why not? Yes No Additional Information for Committee: Personal Expenses (itemize) (Maximum 1,0) Describe Total Resources Total Expenses ESTIMATED FINANCIAL NEED: (Total Resources minus Total Expenses) Continued on next page TOTAL EXPENSES Page 4 of 5
VIII ESSAY (Personal Statement) SECTION Essay Instructions The personal statement is a very important part of the review process Without it, your application will not be considered for funding In 1-2 pages, please carefully consider your reasons for wanting to live at International House Please discuss what you want to contribute to the community, accomplish and take away with you Describe any special circumstances that you want the Financial Aid Committee to consider in reviewing your application, including how your financial situation may have changed recently (If you received aid in Fall semester, please submit a new essay) In addition to your 5 words or less essay, please include a 1-2 paragraph summary (190 words or less) of your essay in the same Word document This is where you to briefly state your key issues for the financial aid committee s review PDF documents will NOT be accepted Please submit your Personal Statement (Essay) and Summary in one Word Doc to the appropriate Financial Aid manager via email attachment by the deadline Make sure the file name includes your last and first name Please read and sign the following statement IX AGREEMENT & STATEMENT WITH E-SIGNATURE I understand that financial aid depends on adherence to International House community standards for residents and the University s Code of Conduct Any violation of these standards may lead to disciplinary action, including termination of residence and withdrawal of the entire room and board financial aid grant I further understand that upon violation of such rules and the University s Code of Conduct, I will be responsible for reimbursement to International House the amount of the grant that was applied towards room and board fees from the time of move-in until the time of any premature termination of the room and board contract I hereby certify that to the best of my knowledge all information furnished in this application is complete and correct I agree to notify the Financial Aid Program Coordinator at International House in writing and within ten days of any change in my financial situation that involves the receipt of 5 or more income or other financial resources than projected in this application I will provide, if requested, official documentation, including income tax returns, necessary to verify information provided in this application Signature Date Submit this Form, the Word Essay/Summary doc, Unofficial Transcript & If you are a US citizen or Permanent Resident, your FAFSA form to: International Students: Bonnie Johnston, ihousefinancialaid@berkeleyedu, 510 642-2196 US Students and Permanent Residents: Shylah Hamilton, usfinaid@berkeleyedu, 510 642-8676 REMINDER: The Deadline for Spring 2017 Financial Aid Application is Thursday, November 10, 2016 by 4:30 PM Pacific time International House * 2299 Piedmont Avenue * Berkeley, CA 94720 USA Visit our website: http://ihouseberkeleyedu Page 5 of 5