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Banking details

Please print in BLOCK CAPITALS


Your details

Student ID Number 2 4 3 7 2 3 Date of birth 05/06/1998

Surname (family name) .


Forename(s) Kirti

Patti Harnam Singh, Siyana, Bulandshahr,


Uttar Pradesh
Student address
India
Postcode 245412

Contact telephone number +91-7536062877

Email address Kirtilodhikm@gmail.com

BANK ACCOUNT DETAILS


The account must be of a type suitable to receive payments.
If you are in any doubt please check with your bank.

Name of bank/building society

Bank address

Account holder’s name


(if not your own)

Bank account no.

SWIF T CODE

IBAN

I confirm that these details relate to my nominated bank account into which I authorise
Buckinghamshire New University to credit any monies due or payable to me.

Signature Date 13/12/2023

Office use only

Input date Signature

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