ACADEMIC 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
*
Tuition
Registration $150
Supply/Book Fee (22-23) $250
Extended Care (morning & after) $250
$35 Daily Before/After Care fee
Before care $100
After care $150
Uniform bundle $160 (5 uniform shirts & uniform zippered sweatshirt) Required for new students.
Uniform shirt $25
Uniform zippered sweatshirt $35
Invoice Number (if applicable) or any other applicable information needed to submit your payment:
Email (to provide you with a receipt)
*
example@example.com
Payment (total of all payment selections above-tuition, before care, aftercare, etc)
*
prev
next
( X )
USD
Provide the payment amount
Credit Card
First Name
Last Name
Credit Card Number
Security Code
January
February
March
April
May
June
July
August
September
October
November
December
Expiration Month
2022
2023
2024
2025
2026
2027
2028
2029
2030
2031
Expiration Year
Sign here and press the red submit button to complete your payment
*
Clear
Submit
Should be Empty: