BILLS PAYMENT REFERENCE

ALUMNI BENEFIT PROGRAMRE-APL-0010-00 I Bills Payment Reference I Page 1 of 2

Reminders:

a. Accomplished “Payment Slip” in duplicate copies1st Copy – Bank copy2nd Copy – Client’s copy

b. Company name should always be:“312-STI Alumni Association, Inc.”

c. Make sure to fill all the items with accurate informationto avoid inconvenience

d. May accept Hyphen (-) while space and other specialcharacters are NOT allowed on Reference Number andSubscriber Number Fields

e. Telephone Number Field – numeric only, specialcharacters are NOT allowed

X

150.00

One Hundred Fifty Pesos

X

100.00 1 150.00

150.00

312 - STI ALUMNI ASSOCIATION, INC.

STI ORCA / JUAN DELA CRUZ

2015

A12-STIAA-001

9101234567

Subscriber no.Reference no.

Telephone no.

A. Company Name: 312-STI ALUMNI ASSOCIATION, INC.

B. Subscriber Name: SCHOOL NAME /GRADUATE NAME

C. Reference No: CODE ASSIGNED FOR EACH SCHOOL (CAN BE VIEWED THROUGH ALUMNI WEBSITE)

D. Subscriber No: YEAR GRADUATED

E. Telephone No/ Other details: MOBILE NUMBER

F. Mode of Payment: Cash/Check

G. Amount of Payment:

(In Figures) Php150.00

(In Words) One Hundred Fifty Pesos

H. Payment details: Cash or Check Payment

ACB

D E

GF

H

ALUMNI BENEFIT PROGRAMRE-APL-0010-00 I Bills Payment Reference I Page 2 of 2