Review and confirm

You will send

NGN 37,879.00

Country or Region

India

Northern Arizona University will receive

US$500.00

You Selected

Debit / Credit in NGN

First Name

John

Last Name

Doe

Address 1

ABC, H-63

Address 2

-

City

Lucknow

State/Province

Uttar Praesh

Zip/Postal Code

226024

Country

India

Phone Number

+9185749652

Email

johndoe124@gmail.com

The person filling out this form is

Student

Student ID

8574968

First Name

Rajendra

Middle Name

Kumar

Last Name

Singh

Date of Birth

06/13/1990

Program Study

Graduate

Expected year of program completion

Not applicable

Student Email

rajednrakr.41@gmail.com