School Fee Payment Form
123 Maple Street Anytown, PA 17101 / www.acmescityuniversity.com / (123) 1234567
Student Name
First Name
Last Name
Student ID
Grade Level
Phone Number
Please enter a valid phone number.
Email
example@example.com
Course/Program
School Year
e.g 2020, 2021, 2022
Parent/Guardian Name
First Name
Last Name
Parent/Guardian Phone Number
Please enter a valid phone number.
Parent/Guardian Email
example@example.com
Select the items you want to pay
Categories:
All
All
Tuition Fee
Books
Virtual Class Equipment
School Supplies
Uniform
Merchandise
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Tuition Fee
School Tuition
One year school tuition fee
$
3,000.00
Miscellaneous Fee
Miscellaneous stuff
$
3,000.00
Books
Art Book
A book about arts.
$
25.00
Science Book
A book about Science.
$
25.00
Math Book
A book about Math.
$
25.00
English Book
A book about grammar.
$
25.00
Virtual Class Equipment
Tablet Device
Android Tablet Device
$
199.00
Headset
Headset with microphone for online classes.
$
25.00
Webcam
Webcam HD quality 1080 resolution
$
59.00
Pen for Tablets
Pen for tablets that have high precision.
$
100.00
School Supplies
Pens, Pencils, Coloring Materials Pack
Collection of pens, pencils, and coloring materials.
$
50.00
Notebook and Paper Materials Pack
Collection of notebooks, bond papers, etc.
$
30.00
Uniform
School Uniform Daily
Daily and regular school uniform
$
80.00
Physical Education Uniform
Daily and regular school uniform
$
80.00
Merchandise
School Shirt
Shirt with school logo
$
15.00
Hoody
Hoody with school logo
$
20.00
Payment Method
Cash
Check
Bank Transfer
Direct Deposit
Other
Date Signed
-
Month
-
Day
Year
Date
Parent/Guardian Signature
Submit
Should be Empty: