International Student Need Analysis Worksheet



International Student Need Analysis Worksheet for Academic Year 2017-18

(please use financial data from 2016)

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 full-time, degree-seeking students (no visiting students) who cannot file the FAFSA due to citizenship restrictions; graduate/professional students may skip the parental information section and simply fill out the student information section.

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

• Supporting documentation for all requested figures is required

Check here if you are applying as a Davis United World College Scholar □

(e.g. have graduated from a Davis UWC School)

Parent Information (All income information should be listed in U.S. Dollars. Please attach any supporting documentation such as bank balance, tax returns, etc.).

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

|by the parents in the household from January 1, 2016 to December 31, 2016): | |

|Number of family members enrolled at a college or university (at least half-time) from January 1, 2016 to December 31, | |

|2016 (not including parent/s): | |

| | |

|2016 income |$ |2016 income (mother/stepmother): |$ |

|(father/stepfather): | | | |

| | | | |

|Income tax paid to home nation’s government |$ |Parental income received in 2016 that was not taxed by |$ |

|or US government in 2016 | |home nation’s government or by US government: | |

|Net worth of parent’s liquid assets as of |$ |Net worth of parents’ investments as of today (rental |$ |

|today (cash, savings, checking accounts): | |property, trust funds, stocks, bonds, mutual funds, | |

| | |etc) Do not include value of life insurance or | |

| | |retirement funds: | |

|Net worth of parents’ business as of today: |$ |Age of older parent: | |

| | | | |

|Home value as of today (if you do not own |$ |How much do you owe on your home as of today: |$ |

|your home, list the monthly rent): | | | |

International Student Need Analysis Worksheet Page 2

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

|2016 income (student): | | | |

| | | | |

| | | | |

| |$ | | |

|Income tax—if any—paid by student to home|$ |Student income received in 2016 |$ |

|nation’s or U.S. government in 2016 | |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: | |

Additional Resources (List any additional resources that you expect to receive during the 2017-18 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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