Fecha - Ulacit  · Web viewMonth_____Day_____Year_____ Global Education Office, I (full name) _____, passport/ID number_____authorize the Universidad Latinoamericana de Ciencia y

Month_________Day_______Year________

Global Education Office,

I (full name) __________________________, passport/ID number______________authorize

the Universidad Latinoamericana de Ciencia y Tecnología (ULACIT), to charge my credit or

debit card number______________________with expiration date_______________, the

amount of dollars $ __________________or amount in colones ¢ ____________.

The above charges are due to: _______________________________________

_____________________________

Signature

Important:

Please, enclose the following documents:

Copy of both sides of the ID or main page of the passport. Copy of both sides of the card. Please send this form thoroughly filled out to: [email protected] The information in this document may be verified at any moment during the enrollment process. Illegible forms will be sent back. We advise applicants to fill it out using Microsoft word and print it

only to be signed (this form is expected to be sent in PDF format).