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This form should be filled only if you have transferred the US$450 as the 1st installment or payment for your registration in the educational provider you had selected. Please use the following bank account information:

Account holder: Global Fast Agency
Bank: Commerce Bank
Account Number: 8301-144720
ABA Nro. 067010509
Address: 220 Alhambra Circle, Coral Gables, Florida 33134, USA

* Required  
Name *
Last Name *
Phone  *
Address *
E-mail  *
   
Application information:  
Institution  *
Program  *
Number of weeks  *
Start date  *
English level  * Beginner Intermediate Advanced  
Accommodation:   *
Homestay
Student residence
Hotel
Apartment
None
Special Requirements or Comments  
Information about your payment:
Transference Date:  *  
Amount:  *
Reference Number:

Note 1: I know and accept the refund policy of the Institution I applied.

Note 2: Global Fast Agency will send you a receipt once the wire transfer is received as well as the further documents for Visa requirement purposes.