UNIVERSITY OF LONDON EFE

Fee for Certification/Transcripts of Academic Record as an

EXTERNAL Student

TO BE COMPLETED BY ALL APPLICANTS

(For use in Fees Office)

Title (Mr, Mrs, Miss or other title) Name (Please underline your family name or surname)

Address

Email address
Telephone number

Fee Enclosed: £

Please select from the following methods of payment:

Online Cheque Banker’s Draft

If you have paid online please insert your six digit transaction code here:

UOL

Formal receipts are not sent automatically but are available upon request.

If you have paid by Cheque or Banker’s draft and require a receipt please tick Yes and if you
do not require a receipt please tick No.

Yes No

Signature: ___________________________________________ Date: ____/_____/___

022016 EXT CERT TRANS