Renaissance Academy

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Donations and Activities

Kindergarten - 9th Grade

Student's Name and Grade	Last	-	First	-	Grade
Student's Name and Grade

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]

Library Fine:

Item Subtotal:

$0.00

Misc Donation:

Item Subtotal:

$0.00

Description of Donations

AP Test Fee:

$99.00

Quantity:

Item Subtotal:

$0.00

What test are you paying for?	[1]
What test are you paying for?	[2]
What test are you paying for?	[3]
What test are you paying for?	[4]
What test are you paying for?	[5]
What test are you paying for?	[6]
What test are you paying for?	[7]
What test are you paying for?	[8]
What test are you paying for?	[9]
What test are you paying for?	[10]

Space Place Program:

Item Subtotal:

$0.00

Space Place Program Donation Code

China Trip (per person):

$438.50

Quantity:

Item Subtotal:

$0.00

Student or Chaperone Full Name				[1]
Mailing Address with City, State, Zip included				[1]
Students Grade - if applicable				[1]
Student or Chaperone Full Name				[2]
Mailing Address with City, State, Zip included				[2]
Students Grade - if applicable				[2]
Student or Chaperone Full Name				[3]
Mailing Address with City, State, Zip included				[3]
Students Grade - if applicable				[3]
Student or Chaperone Full Name				[4]
Mailing Address with City, State, Zip included				[4]
Students Grade - if applicable				[4]
Student or Chaperone Full Name				[5]
Mailing Address with City, State, Zip included				[5]
Students Grade - if applicable				[5]
Student or Chaperone Full Name				[6]
Mailing Address with City, State, Zip included				[6]
Students Grade - if applicable				[6]
Student or Chaperone Full Name				[7]
Mailing Address with City, State, Zip included				[7]
Students Grade - if applicable				[7]
Student or Chaperone Full Name				[8]
Mailing Address with City, State, Zip included				[8]
Students Grade - if applicable				[8]
Student or Chaperone Full Name				[9]
Mailing Address with City, State, Zip included				[9]
Students Grade - if applicable				[9]
Student or Chaperone Full Name				[10]
Mailing Address with City, State, Zip included				[10]
Students Grade - if applicable				[10]

Chinese Summer Camp July 21st-24th:

$190.00

Quantity:

Item Subtotal:

$0.00

July 21st-24th Session				[1]
July 21st-24th Session				[2]
July 21st-24th Session				[3]
July 21st-24th Session				[4]
July 21st-24th Session				[5]
July 21st-24th Session				[6]
July 21st-24th Session				[7]
July 21st-24th Session				[8]
July 21st-24th Session				[9]
July 21st-24th Session				[10]

Chinese Summer Camp July 28th-31st:

$190.00

Quantity:

Item Subtotal:

$0.00

July 28th-31st Session				[1]
July 28th-31st Session				[2]
July 28th-31st Session				[3]
July 28th-31st Session				[4]
July 28th-31st Session				[5]
July 28th-31st Session				[6]
July 28th-31st Session				[7]
July 28th-31st Session				[8]
July 28th-31st Session				[9]
July 28th-31st Session				[10]

Drama

After School Drama VOLUNTEER:

$65.00

Select:

Item Subtotal:

$0.00

After School Drama NON VOLUNTEER:

$105.00

Select:

Item Subtotal:

$0.00

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% additional service fee for foreign cards)
eCheck:	$0.49

Method of Payment:	Credit/Debit Card eCheck
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