Highmark Charter School Fees
             

Lottery Registration

Thank you for your interest in HighMark Charter School for the 2015-2016 school year.  Please fill out the below information and you will be notified once our lottery is open to apply for the 2015-2016 school year.  This submission does not guarantee acceptance by HighMark Charter School.
 
Parent's Information
First Name: Last Name:
Address:
Address:
City: State/Province: ZIP/Postal Code:
Phone: Email:
Student Name and GradeFirst Name Last Name
Payment Information
Method of Payment:
Processing Fees: Credit cards: 3% plus $0.50 ($1.50 min)
                    (+1.5% processing fee for foreign cards)
eChecks: $0.49
Update name from Parent's Information
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's Information
Cardholder's Name:
Billing ZIP/Postal Code:
 
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