WIRE TRANSFER VERIFICATION
NamE
*
Full Name
E-mail
*
Wire Transfer Number
*
Bank Name
*
Receiving Bank
*
CHASE BANK
AMOUNT WIRED
*
MUST BE U.S. DOLLARS
PURPOSE
*
REGRISTRATION OR TUITION
STUDENT'S NAME
*
i)
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
-
Country Code
Phone Number
Please verify that you are human
*
Submit
Number
Should be Empty: