Seattle Central Community College

International Education Programs

Tuition and Fees Wire Transfer Notification Form

This form must be submitted to the International Education Programs Office, along with the wire transfer receipt from your bank, for any wire transfer related to tuition and fees deposits. If you are making a tuition and fee deposit for more than one student, use a separate form for each student. Wire transfers will not be processed until this form and the bank receipt have been received.

Amount of Wire Transfer (in US Dollars): _______________________________ to be used for:

q Tuition / Registration Fees

Student Information

(this information must be included in wire transfer payment details. Please inform your bank.).

Family name:

Given name:

Middle name:

Student ID# (SID), if available:

Date of Birth: Month: Day: Year:

Student Current Address

Street and number:

City:

Country:

Postal code:

Details of wire transfer

Name of sender (family, given, middle):

Relationship to student (parent, student, agent, other):

Address of sender (complete all lines below)

Street and number:

City:

Country:

Postal code: E-mail: Fax Number:

Date wire transfer was made: Day: Month: Year:

Send this completed form via fax or email -- Email: iepsccc@sccd.ctc.edu , Fax: 206-587-3868.

Due to high volume of wire transfers received, notification of receipt of funds will only be made upon request. Keep a copy of this form for your records along with the wire confirmation code from your bank.