International Student Need Analysis Worksheet



International Graduate Student Need Analysis Worksheet for Academic Year 2018-19

(please use financial data from 2017)

Last Name First Name MI UNC PID

Address City State/Province Postcode/Zip

Country (if other than USA) Phone Email Address

• This worksheet is only applicable to degree-seeking graduate/professional students.

• Worksheet must be filled out in English, with monetary amounts given in U.S. Dollars

• Supporting documentation for all requested figures is required

Student Information (All income information should be listed in U.S. Dollars. Please attach any supporting documentation.)

|Number of family members (this includes the applicant, spouse, children, and anyone else supported more than 50% within | |

|the household from January 1, 2017 to December 31, 2017). If just the applicant, then enter 1. | |

|2017 income (student): | | | |

| | | | |

| | | | |

| |$ | | |

|Income tax—if any—paid by student to home|$ |Student income received in 2017 |$ |

|nation’s or U.S. government in 2017 | |that was not taxed by home | |

| | |nation’s or U.S. government: | |

|Net worth of student liquid assets as of |$ |Net worth of student |$ |

|today (cash, savings, checking accounts):| |investments—if any—as of today | |

| | |(rental property, trust funds, | |

| | |stocks, bonds, mutual funds, etc):| |

|Net worth of student business—if |$ |

|applicable—as of today: | |

|Monthy rent, or current home value if you |$ |If applicable, how much do you owe on your home as of |$ |

|own your home. | |today: | |

Additional Resources (List any additional resources that you expect to receive during the 2018-19 academic year. This includes but is not limited to assistance from outside sources (relatives), scholarships, grants, tuition waivers, sponsorships, and fee reductions):

|Amount |Source |Amount |Source |

|$ | |$ | |

|$ | |$ | |

I affirm that the above information is true and accurate to the best of my knowledge.

Signature Date

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