Parent Payment Form

PARENT PAYMENT FORM
The option of paying on-line includes a convenience fee added to your total payment amount to cover card processing fees. Thank you for your understanding.
Parent Information
Parent/Guardian Name*

First NameLast Name
Email Address*
example@example.com
Phone Number
Student Information
Student Name*

First NameLast Name
Select Campus*
Payment Disbursements
Please enter the amounts that you’d like to apply to each category.

Payments*

Tuition$1.00

Enter Amount ($)

Daycare$1.00

Enter Amount ($)

Technology Enhancement Fee ($50.00)$50.00

High School Sport Fee ($75.00 per sport)$75.00

Jr. High Sport Fee ($35.00 per sport)$35.00

Elementary Snack Card - $15 (20 snacks) per card$15.00

Quantity of Cards

Elementary Lunch Tickets - $15.00 (5 lunches) per strip$15.00

Quantity of Ticket Strips

Spring Fundraiser In-lieu Payment - $100$100.00

The student will receive prize points, but no dinner or raffle tickets will be purchased.

Other (Please specify details at the bottom of the Form) $1.00

Amount ($)

Subtotal $0.00Tax $0.00Shipping $0.00Total $0.00

PARENT PAYMENT FORM