Deferral Fee Payment Form

Please scan in and

return to:

Complete the details below. Your full name must be printed or typed as it appears on your passport.

HULT FINANCE

___________________________________________________________________________________________________
Last Name

First Name

Student ID

E-Mail:
Hult.Finance@hult.edu

___________________________________________________________________________________________________

OR to your Hult
representative

I am applying for the following course at Hult International Business School:

Contact No.

Email

Full-time MBA at the following home campus:

Boston

San Francisco

London

Dubai

Shanghai

San Francisco

London

Dubai

Shanghai

Executive MBA:
London
Master of Finance:
Boston

Master of International Marketing

Boston

Master of International Business:

Boston

San Francisco

London

Dubai

San Francisco

London

Master of Social Entrepreneurship

San Francisco
Shanghai

Bachelor Program:
London

San Francisco

c I have enclosed the deferral fee of USD1,000. I understand that my deferral fee is non-refundable.
Please select your payment method for the deposit:
c VISA
c MasterCard


Cardholders Name (as written on the card):_______________________________________________________________________
Credit Card Number:

3-Digit CSC Number:

Expiry Date:

The 3-digit CSC# is located

on the back of your card,
following your account number.

Signature (Cardholder):

Date:

Bank transfer (please include your name on the transfer form).

I understand that all bank and transaction fees are my sole responsibility and that Hult bears no responsibility.
Senders Name:

Last name

First Name

Middle Name

Credit Suisse AG, Paradeplatz 8, 8070 Zrich SKA, Switzerland

Account Name: Hult International Business School AG
Swift Address: CRESCHZZ80A
If paying in USD, account no: 0835-1536336-22 USD IBAN: CH82 0483 5153 6336 2200 0
If paying in GBP, account no: 0835-1536336-22-1 GBP IBAN: CH55 0483 5153 6336 2200 1
If paying in AED, account no: 0835-1536336-22-3 AED IBAN: CH98 0483 5153 6336 2200 3

It is very important that you ensure that your name and Hult Student ID appears on the bank transfer so that we can quickly credit your account with the
payment. You will find your Student ID directly under your name on your Hult application web page. Please make sure to instruct your bank to include your
Student ID and full name in the reference information.

Signature (Student):

Date: