Direct Deposit Request

Student Name*
First Last
Student ID#
Phone
Email
Banking Information
- New account
- Change to existing account
Please check box above to indicate new account or change to existing account.
Account Type*
- Checking
- Savings
Bank Name*
Name on Account*
First Last
Transit Routing# (ABA)*
(Note – this must be 9 digits)
Please Confirm the Transit Routing# (ABA)
(Note – this must be 9 digits)
Account #*
Please Confirm the Account #
Authorization
I authorize McDougle Technical Institute (MTI) to deposit funds into the above financial institution to the account specified above. In the case of an error, I authorize McDougle Technical Institute (MTI) to direct the financial institution to return the funds to MTI.
Signature
Date
Date Format: MM slash DD slash YYYY
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Please upload a voided check or Bank form providing all bank transit routing/ABA information must be included with submission of this form.*
Phone
This field is for validation purposes and should be left unchanged.

Banking Information