Renaissance Academy - Fees
             
Donations
Kindergarten - 6th Grade
 
Student's Name and GradeLast-First-Grade
 
Junior Academy:   $   Item Subtotal:  
$0.00
Student Name
Field Trip Donation Amount:   $40.00   Quantity:   Item Subtotal:  
$0.00
Student's First and Last Name [1]
Grade [1]

Student's First and Last Name

[2]
Grade [2]

Student's First and Last Name

[3]
Grade [3]

Student's First and Last Name

[4]
Grade [4]

Student's First and Last Name

[5]
Grade [5]

Student's First and Last Name

[6]
Grade [6]

Student's First and Last Name

[7]
Grade [7]

Student's First and Last Name

[8]
Grade [8]

Student's First and Last Name

[9]
Grade [9]

Student's First and Last Name

[10]
Grade [10]
After School Activity:   $   Item Subtotal:  
$0.00
Activity
Film Club:   $55.00   Quantity:   Item Subtotal:  
$0.00
Library Fine:   $   Item Subtotal:  
$0.00
Background Check:   $20.00   Quantity:   Item Subtotal:  
$0.00
Misc Donation:   $   Item Subtotal:  
$0.00
Description of Donations
Space Place Program:   $   Item Subtotal:  
$0.00
Space Place Program Donation Code
 
Total:
$0.00

Payer Information
First Name: Last Name:
Address:
Address:
City: State/Province: ZIP/Postal Code:
Phone:
Email:
Payment Information:
Processing Fee Rates:
Cards:3% plus $0.50 ($1.50 min)
(1.5% surcharge for foreign cards)
eCheck:$0.49
Method of Payment:
 Update Name from Personal/Organizational Information
Name on Account:
Routing Number:
Account Number:
Institution:
Name on Card:
Account Number:
Expiration Date:
Billing Street Address:
Billing ZIP/Postal Code:
 Change Payment Method

Please be aware that payments will reflect on your statement as

CBT*RENAISSANCE ACADE and CBT*SVC FEE RENAISSAN


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