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FLS International SEVIS Fee Payment Request Form

Please fill out the form and send it to FLS Administrative Office. Fax: 626-795-5564 E-mail: admissions@fls admissions@fls.net net

Student s Name Student's FLS ID Number

Credit Card Type yp Card Number Security Code Expire Date Card Holder's Name Card Holder's Address

Student's City of Birth Student's County of Birth Student's County of Citizenship