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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