Application Form - Mohawk College Page 2
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2INTERNATIONAL EDUCATION
PAYMENT INFORMATION FORM
1. APPLICANT / STUDENT INFORMATION
Family Name
Given Name(s)
Date of Birth
Passport #
(Day/Month/Year)
(if applicable)
Student # / Application #
(if applicable)
2. RECEIPT MAILING INSTRUCTION (Please select one only)
□ Attach to Letter of Acceptance
□ Pickup
□ By email: _________________________________________________________
3. METHOD OF PAYMENT
□ Certified Cheque | Money Order | Bank Draft
Please make certified cheques, money orders, and bank drafts payable to Mohawk College
and submit in person to Mohawk College Fennell Campus Room J107 or
mail to 135 Fennell Avenue, P.O. Box 2034, Hamilton, ON, Canada L8N 3T2
(Attention: International Education Department, Room J107)
□ Bank Transfer (Please contact our office for details)
□ VISA or MasterCard (by fax only: 905-575-2362)
Card Number:
-
-
-
Expiry Date:
CVD / Security Code:
(Month / Year)
(back of card)
Amount
$ ________________
Cardholder’s Name: __________________________________________________________________________________________
Signature of Cardholder: ______________________________________________________________________________________
MOHAWK COLLEGE | INTERNATIONAL PARTNERSHIPS & RECRUITMENT | J107 | P.O.BOX 2034 | Hamilton, Ontario L8N 3T2 CANADA
P 905-575-2254 | F 905-575-2362 | E
intered@mohawkcollege.ca
| W
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