International Student
Bank Certification

Applicants, please present this form to your bank.

Instructions: You may (1) print this form, then fill it out by hand; or (2) fill out the form online, then print it. Either way, the bank official must sign his/her name where indicated. Directions for submitting this form by mail are near the bottom of the page.

To be completed by bank or other financial agency officials

We hereby certify the following information regarding the account held by:
Last:	First:	Middle:
Date account opened (mm/dd/yyyy): Total deposits for past year in U.S. dollars: $ Present account balance in U.S. dollars: $
Name of bank or agency:
Official's Signature: ___________________________________________ Date: ___________________
Name of bank official:
Title of bank official:
Address of bank or agency:

Instructions for Submitting Application and Supporting Documents

Please mail your complete application and supporting documents to:

Coastline Community College, Le-Jao Center
Attn: Linda Maynard, International Student Advisor
14120 All American Way
Westminster, CA 92683

Phone Inquiries:
(714) 241-6184, ext. 17416

Return to the International Students home page.