Maria Montessori Academy
2018-2019 MMA Jr. High Student Fees

Student's Name and ID NumberLast Name,First Name,Student Number
Text Books & Electives:   $30.00   Item Subtotal:  
Computer Lab:   $10.00   Item Subtotal:  
Science Lab:   $25.00   Item Subtotal:  
CTE / Health / Digital Tech:   $20.00   Item Subtotal:  
Fieldtrip Fees:   $110.00   Item Subtotal:  
Parent / Guardian Info
First Name: Last Name:
City: State/Province: ZIP/Postal Code:
Phone: Email:
Payment Information
Method of Payment:
Processing Fees: Credit cards: 3% plus $0.50 ($1.50 min)
                    (+1.5% processing fee for foreign cards)
Update name from Parent / Guardian Info
Name of Individual
on Checking Account:
Name of Individual
on Savings Account:
Name of Business
on Checking Account:
Bank Routing Number:
Bank Account Number:
Credit Card Number: (Type number or swipe with cursor in this empty field)
Expiration Date: /
Card ID (CVV2/CID) Number: What is the Card ID?
Cardholder Information (exactly as it appears on your statement)
  Update from Parent / Guardian Info
Cardholder's Name:
Billing ZIP/Postal Code:
Please be aware that payments will reflect on your statement as 

Schools 800-764-0844 Clinton UT

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