帮忙看看这个表格怎么填

拎破轮UID: 2622706

那个agency name 和
breakdown of payment该填什么啊

TELEGRAPHIC TRANSFER FORM

Following is a form to make your telegraphic transfer a little easier.
This form is to be completed and returned on the day of Bank Transfer.
Delays will occur if all information is not given. Please fax to:

Charles Sturt University

Admissions Office

Locked Bag 676

Wagga Wagga


Facsimile:
+61 2 6933 2063

Please note bank fees may occur during this transfer, if so you will be required to reimburse
Charles Sturt University the bank fee when you commence your studies.


Telegraphic Transfers must be made in Australian dollars to

Name of Bank:
Australia & New Zealand (ANZ) Banking Group
Name of Branch:
Wagga Wagga

98-100 Baylis Street

Wagga Wagga
NSW
2650

Australia
SWIFT Number:
ANZBAU3M
BSB Number:
012 823
Account Number:
8373 59576
Account Name:
Charles Sturt University

AGENCY NAME:
..................................................................................................

STUDENT NAME:
********..........................................................................

COURSE:
*********...........................

AMOUNT PAID
AUD$
******

BREAKDOWN OF PAYMENT:
学费+医疗保险？



BANK TO BANK INFORMATION

FROM:
*********************************...................... China......................................

Name of Bank and Telegraphic Transfer ref. no.
Country

TO: ***********......................




Name of Affiliated Bank in Australia

拎破轮UID: 2622706

有没有知道的帮帮忙啊！小的谢谢大家

liushiyangUID: 2643876

你好啊，你也是7月份去查尔斯的嘛？我手中也有和你一样的担子呢~