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October 10, 1995 - Image 33

Resource type:
Text
Publication:
The Michigan Daily, 1995-10-10

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*NO FEE *SPECIAL STUDENT RATE *TRAVEL DISCOUNTS *PHOTOCARD
PLEASE TELL US ABOUT YOURSELF
Print Pull same: First,Middle Initial, Last Social Serurity Numtber- Date of Birth (Month/'Day/Year) Mother's Maiden Name
Your Permanent or Parents' Home Address Apt. No City orTown State Zip
Yoar Permanett Area Code and Phone Member First ea Last Nanme under whict rour permanent phone is i sted witt Directory'Assistance
N PLEASE TELL US ABOUT YOUR SCHOOL
Z Fall Name of Cmllege/Universany (Please Do Not Abbreviate) IBranch/'CampusOfcilShoZp
O ___________
o Your MaiingAddress at School (If P fferent from Permanent Address) Apt No. City or-Town State Zip
YoarArea Code and Phone Number at School Frst and Laot Name under- ahich yourschool phone is listeda Cit Drectory Assistance
Your Class: C Fresh (A) C Jutior (J) C Grad Student (G) 7 Permanet U. S, Resident? Address to mhich Pou want pour turd and hilling statement mailed
Q Soph (B) C Senior (S) C Yes C No C Permanent C School
OTHER IMPORTANT INFORMATION
aW Money Market/ Investment Accosnt? D Yes Cl No You donot have ao teasue spouse's income, alimonachild sapport or separate mtaintenance payments paid if you
cc Bath Matte: ae nt relyng or nhem to nstabih credtwortiness. Fir ancial aid atd tuition ame not applicale as sources of income.
w- Cekn cout ~s CN Annual Source(s): QFull-timejob CSsnrmerfob CSavings
0. Incom e 4)Q Part-time Job QCAllomance C Stipend

ZO Bank Name:
Q Savings AccoantfCMs/Treasurn Bills? C Yes C No
u Bank Name
VERIFICATION OF SCF

Name of Employer (Most Beent)
EmployerArea Code and Phote Number_
HOOL ENROLLMENT

4

PLEASE SIGN HERE
Icertify that I meet and agree so all Citibank credit terms and conditions of offer on tne otner side. Please allow 30 days to process this application.
x
Appicant's Signature Cute
CITI BAN(OQ®
ICKAP 45509 BXO&& &&7U WE'RE LOOKING OUT FORYOU."

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