HSE Payment Moscow (original) (raw)

Surname, Name, Patronymic

Contract number

Surname, Name, Patronymic (use Cyrillic characters, copy the spelling from your contract)*

Contract number (use Cyrillic characters, copy the spelling from your contract)*

Dormitory

Year of education

Payer (use Cyrillic characters, copy the spelling from your contract)*

Phone (use Cyrillic characters, copy the spelling from your contract)*

E-mail (use Cyrillic characters, copy the spelling from your contract)*

Payment for period*

Amount:

Amount* rubles

kopecks