International Student Office Housing Sponsorship Form

International Student Office

Housing Sponsorship Form

Section 1- Sponsor Statement/Applicant Information - (enter name as per passport)

I,

Full Name of Sponsor

, hereby certify that I am willing and financially able to provide

Last Name

First Name

Middle Name

with free housing and meals for the duration of his/her education while attending Suffolk County Community College.

My relationship to the applicant:

(e.g.: spouse, parent, brother/sister, friend, etc.)

Attach a copy of the sponsor's proof of residence: Deed

Lease

Utility Bill

Address of residence offered to student:

Number and Street

City

( _ _ _ ) _ _ _?_ _ _ _

Home Phone Number

State

( _ _ _ ) _ _ _?_ _ _ _

Mobile Phone Number

ZIP or Postal Code Email Address

Section 2 - Affirmation

By signing this document, I understand that I am making a housing arrangement commitment in which no type of service is required in exchange for this benefit. I understand that a sponsor who fails to provide promised support may cause pain and suffering to the student, including forcing them to stop attending school and exit the United States. I do not expect the student to be able to support him or herself through employment. Employment for students is limited and strictly controlled by the United States Citizenship and Immigration Services. For more information on F-1 student employment eligibility, visit .

Signature of Sponsor

Subscribed and sworn to before me:

Month/Day/Year

Printed Name of Sponsor Signature of Notary Public

Notary Stamp or Seal

Suffolk County Community CollegeInternational Student Office, Kreiling Hall, Room 102 533 College Road, Selden, NY 11784-2899 USAPhone: (631) 451-4773 Fax: (631) 451-4708

IS-HS

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