Academic Program Payment Form

ACADEMIC PROGRAM PAYMENT FORM
Student's Name *

First Name Last Name
2nd Student's Name

First Name Last Name
3rd Student's Name

First Name Last Name
4th Student's Name

First Name Last Name
Name of parent or person making payment *

First Name Last Name
Email *
example@example.com
Please select what your payment is for (you can choose more than one option) *

Tuition Registration $150 Supply/Book Fee $175 Morning Care 7:30am-8:30am $75 Aftercare 3:15pm-4:15pm $75 Extended Care (morning & after) $150 $25 Daily Before/After Care fee 1 Slice of pizza & water $5.00 2 Slices of pizza & water $7.00 1 Slice of gluten free pizza & water $5.00 2 slices of gluten free pizza & water $7.00
Invoice Number (if applicable) or any other applicable information needed to submit your payment:
List academic program that you are making a payment OASN K-12 ED or OPA (this is important for accounting purposes) *
List academic program that you are making a payment for: *

OASN K-12 Education Division Ocala Preparatory Academy
Email (to provide you with a receipt) *
example@example.com

Payment (total of all payment selections above-tuition, before care, aftercare, pizza, etc) *

USD Provide the payment amount