Application for Financial Assistance

for the 2014 –15 Academic Year
— INTERNATIONAL STUDENTS —
Office of Admission  •  Franklin & Marshall College
P.O. Box 3003  •  Lancaster, PA 17604-3003
(717) 291-3951
FAX # (717) 291-4389
www.admission.fandm.edu
Students who wish to be considered for financial assistance by Franklin & Marshall College for the 2014 –15 academic year must complete and return
this form, with the admission application, to the Office of Admission, Franklin & Marshall College, P.O. Box 3003, Lancaster, PA 17604-3003, USA.
Please Note: The admission process for international students may be influenced by their ability to be financially self-supporting.

Ha

Phong

The

  1. Your name _________________________________________________________________________________________________________________________________________________________________
   
              last (family)                             first                     middle
  2. Permanent home address (your family’s home)

_____________________________________________________________________________________________________________________

12/450 Bach Dang, Hoan Kiem, Hanoi, Vietnam

______________________________________________________________________________________________________________________________________________________________________________

  3. Your date of birth

08
25
1996
/   /
________________________________
month/day/year

Vietnam
  4. Country of citizenship ___________________________________________________
Ha Trong Kieu
  5. Your father’s name ___________________________________________________________________________________________________________

43
Age ___________________________________

Teacher
His occupation/title ______________________________________________________________________________________________________________________________________________________

Hanoi College of Education
His employer ______________________________________________________________________________________________________________________________________________________________

His home and business e-mail addresses    home ______________________________________________ bus. _______________________________________________________

Nguyen Thi Hoai Le
43
  6. Your mother’s name __________________________________________________________________________________________________________
Age ___________________________________

Tailor
Her occupation/title ______________________________________________________________________________________________________________________________________________________

self-employed
Her employer _____________________________________________________________________________________________________________________________________________________________

Her home and business e-mail addresses    home ______________________________________________ bus. _______________________________________________________

  7. Your parents’ marital status:
[  x ]  married
[  ]  divorced/separated

If parents live separately, a separate form must be completed for each household (you may duplicate this form).
  8. Name the members of your family living in your parents’ household (including ALL dependent members of the household):

Educational information, 2014 –15

Full name of family member

Age

Relationship to you

Ha Trong Kieu

43

Father

Nguyen Thi Hoai Le

43

Mother

Ha The Phong

17

Ha The Duy

13

Brother

Name of school
or college

Trung Vuong

Year of
attendance

8

Tuition and
fees

800

Room and
board

0

Financial
aid

0

Amount of
Parents’
contribution

800

Secondary School

  9. How many persons, including you, depend on the income of your parents for daily living?

4
____________________________

10. How many of these persons depend on the family income for their educational costs?

2
____________________________

AFA–1

000 11. Do you or your parents have money. bank or government verifying salaries listed above. List other U. Does your family employ other people?   [  ]  yes  [ x ]  no  If yes.719 What is the present sale value? $ _____________________ What is owed on home? $ ______________________ 15.000 3.848 savings $ ______________________ 0 family business $ ______________________ other (explain*) $ ______________________ 0 *Explanations _______________________________________________________________________________________________________________________________________________________ 16. signature of father ________________________________________________________________________________________________ date ______________________________________________ signature of mother ________________________________________________________________________________________________ date ______________________________________________ signature of student ________________________________________________________________________________________________ date _______________________________________________ AFA–2 . how much of your household income (before taxes or expenses) came from the following sources? 16. please explain.000 2. please report the make (VW.7485 Euro = $1)?VND ______________ 12. 0.000 11. Give the present value of other family assets in your country: 0 land and buildings (other than family home) $ ______________________ 0 investments (such as stocks and bonds) $ ______________________ 0 money owed to your family (explain*) $ ______________________ b.400 food $ ________________ $ ________________ medical expenses $ ________________ $ ________________ 600 1.PLEASE CONVERT ALL ANSWERS TO UNITED STATES DOLLARS 21.S. PARENTS EMPLOYERS PARENTS EMPLOYERS 0 1. and complete. What is the present exchange rate of your country’s currency to the U.400 clothing $ ________________ $ ________________ entertainment $ ________________ $ ________________ 800 1. This form should be accompanied by a certificate/tax form from employer. 11. WARNING: Providing false information may jeopardize a student’s visa status and furthermore may result in Franklin & Marshall revoking its initial decision to enroll the student.) and the year of manufacture: Huyndai.000 Government Explain: ____________________________________________________________________________________________________________________________________________________________________ 19.S.000 11. how many in the home? _______________ In the family business? ________________ 17.300 household necessities $ ________________ $ ________________ vacations $ ________________ $ ________________ 0 1.S.000 taxes $ ________________ $ ________________ retirement/savings $ ________________ $ ________________ social club memberships* $ ________________ $ ________________ other (specify) $ ________________ $ ________________ *List social clubs to which your parents belong: ________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________________________________________________________________ 14. If your family owns automobiles. dollars ____________________________________________________________________________________________________________ If the assets above produce no income in 12. Does your family own its own home? ___________________________________________________________________________________________________  [ x ] yes  [  ] no   inherited inherited What year was it purchased? ________________________ What was the original purchase price? $ _____________________ 94. During the past year.978 0 father’s work $ ______________________ mother’s work $ ______________________ your work $ __________ 0 0 0 family business/real estate $ ______________________ interest or dividends $ ______________________ other $ __________ 0 pension/annuity/retirement $ ______________________ 13.)? FIRST YEAR SECOND YEAR THIRD YEAR FOURTH YEAR Family savings 11. Fiat. in which countries are these assets held? ____________________________________________________________________________________________________________ 0 List the assets and their values in U. etc.* 47. List agencies/foundations/government to which you are applying for financial aid and amount applied for: ______________________________________________________________________________________________________________________________________________________________________________ 20.115 = $1.000 2. properties or assets in another country?   [  ]  yes   [ x ]  no If yes.S.500 rent or mortgage/housing $ ________________ $ ________________ automobile (not fuel) $ ________________ $ ________________ 800 5. dollar (for example. colleges to which you are applying: ______________________________________________________________________________________________________________________________________________________________________________ CERTIFICATION — We declare that the information on this form is true.000 2.000 insurance (health or property) $ ________________ $ ________________ educational expenses $ ________________ $ ________________ 600 0 2. What did your parents spend or parents’ employers provide to meet your living expenses during the past year? Specific amounts are needed. 2010 ______________________________________________________________________________________________________________________________________________________________________________ 18.400 utilities $ ________________ $ ________________ servants $ ________________ $ ________________ 2. a.000 Relatives/friends Sponsor Family income 2. correct. What amounts will be available for your education in the United States per year (excluding travel to and from the U.