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For Customer Use

For Bank Use

Chulalongkorn University Academic Testing Center (CU-ATC)Registration Report

Chulalongkorn University Academic Testing Center (CU-ATC)Registration Report

Name : Sawang Loyarkat Application No. : 58037786Test Schedule and Fee

Test Date Test Applied Test Time Fee (Baht)9 Aug 2015 CU-TEP 08:30 - 11:30 700.00

Total Registration Fee 700.00

Important Notes :1. Payment deadline is on 13 Jul 2015

2. Non payment or payment after the payment deadline will result in

an automatic cancellation of the registration.

3. Payment made by using the bank's deposit slip will also result in an

automatic cancellation of the registration.

4. Applicants who deposit money into CU-ATC account after the payment

deadline or with improper methods will not be able to get a refund

and will not be allowed to defer registration fee.

5. The applicant must keep this part as an unofficial/temporary receipt.

Bank Use Only

Received By ............................

Date ......./......./.......

Signature and Stamp

For Deposit into CU-ATC account at :

Siam Commercial Bank PCL.A/C No : 045-3-03857-1 () (15/15)

Krung Thai Bank PCL.Product Code : 80078 (10/10)

:

Deposit by/Tel. ........................................

Name : Sawang LoyarkatApplication No. (Ref.1) : 580377860580713Ref.2 : 182040000703862Amount (Baht) : 700.00

Amount (In Word) :-Seven Hundred Baht-

Bank Use Only

Received By ............................

Date ......./......./.......

The applicant may pay fees at any Siam Commercial Bank or Krung Thai Bank counter, Internet Banking or ATM in Thailand.

Payment deadline is on 13 Jul 2015 **Cash Payment Only**

099400016390802 580377860580713 182040000703862 70000