MBA PROGRAM PAYMENT INFORMATION

MBA PROGRAM
PAYMENT INFORMATION
Check information
Checks, in Euros, may be made payable to "CCIR Paris IDF – HEC Recettes". Please include
your name, MBA entry date along with your check, and send it to :
HEC MBA Program
Attn.:
HEC MBA Admission Office
1, rue de la Libération
78351 Jouy-en-Josas cedex
FRANCE
Wire transfer information
BNP PARIBAS
RELEVE D'IDENTITE BANCAIRE
- CADRE RESERVE AU DESTINATAIRE DU RELEVE _____ ___ ___ ___ ___ ___ __ ___ ___ ___ ___ ___ ___ ___
CCIR Paris IDF HEC RECETTES
1 Rue de la Libération - 78350 JOUY EN JOSAS
DOMICILIATION
B.N.P. PARIBAS Centre d'Affaires de PARIS ETOILE ENTREPRISES
83, Avenue Charles De Gaulle - 92200 NEUILLY-sur-SEINE
CODE BANQUE
30004
IBAN
:
CODE GUICHET
01587
NUMERO DE COMPTE
00026011789
CLE RIB
80
FR76 3000 4015 8700 0260 1178 980
(International Bank Account Number)
Code SWIFT (ex BIC) : BNPAFRPPPGA
-Indicate your name and MBA entry date on the wire
Payment may be made in Euros.
Please send us a scan of the receipt of the wire order, indicating the exact amount of the transfer and the
date it was made, in order to facilitate identification of the transfer.
Be aware that wire transfers can take several weeks to appear on our account.
Credit Card Information
For Credit Card payment, please send a scanned copy to your Admission Officer by email.
We advise you to contact your bank in order to authorize this payment.
Credit Card Payment Authorisation
(secured payment by CCIP)
I, the undersigned
……………………………………………………………………………..………………………………
certify that the following documents are correct and authorise HEC Paris to charge my credit card with the amount
due for my registration to the ………………………………….., institution …………………………………...
Type of credit card:
 VISA
 MASTERCARD
 AMEX
*
Credit card n°:
*Please write down the last 3 digits showing on the back of your credit card 
Ex pira tion d a t e :
Dat e o f bir th
P ass por t
:
# :
For CB with a foreign account please indicate your date of birth and passport number
I hereby confirm that my line of credit is sufficient to cover the payments mentioned below:
Date of invoice(s)
Amount in €
(in
figures and words)
Total amount invoiced
Date of withdrawal
Amount in €
(in
figures and words)
Total amount invoiced
The participant must:
1. tick the credit card payment option on the registration form;
2. sign and hand write “read and approved” on the credit card payment authorisation;
3. authorise HEC Paris to withdraw his/her credit card:
- with the amounts mentioned on the credit card payment authorisation, on the dates quoted on the credit card payment
authorisation;
4. have a sufficient line of credit to cover the amounts due (sometimes different from the cash withdrawal credit);
5. has the right to withdraw at any time this credit card authorisation payment and choose any other means of payment;
Date…………………………………………….………
Participant signature preceded by "Read and approved"
March 2008