SIPlive: Edwards County Registration (L.?)

Student's First and Last Name

Grade Level

Student's First and Last Name

Grade Level

Student's First and Last Name

Grade Level

West Salem Grade School

Book Rental

WSGS: Early Childhood:

$55.00

Quantity:

Item Subtotal:

$0.00

Student's First and Last Name	[1]
Grade Level	[1]
Student's First and Last Name	[2]
Grade Level	[2]
Student's First and Last Name	[3]
Grade Level	[3]
Student's First and Last Name	[4]
Grade Level	[4]
Student's First and Last Name	[5]
Grade Level	[5]
Student's First and Last Name	[6]
Grade Level	[6]
Student's First and Last Name	[7]
Grade Level	[7]
Student's First and Last Name	[8]
Grade Level	[8]
Student's First and Last Name	[9]
Grade Level	[9]
Student's First and Last Name	[10]
Grade Level	[10]

WSGS: Grades K-8:

$65.00

Quantity:

Item Subtotal:

$0.00

Student's First and Last Name	[1]
Grade Level	[1]
Student's First and Last Name	[2]
Grade Level	[2]
Student's First and Last Name	[3]
Grade Level	[3]
Student's First and Last Name	[4]
Grade Level	[4]
Student's First and Last Name	[5]
Grade Level	[5]
Student's First and Last Name	[6]
Grade Level	[6]
Student's First and Last Name	[7]
Grade Level	[7]
Student's First and Last Name	[8]
Grade Level	[8]
Student's First and Last Name	[9]
Grade Level	[9]
Student's First and Last Name	[10]
Grade Level	[10]

WSGS: Technology (Grades 6-8):

$20.00

Quantity:

Item Subtotal:

$0.00

Student's First and Last Name	[1]
Student's First and Last Name	[2]
Student's First and Last Name	[3]
Student's First and Last Name	[4]
Student's First and Last Name	[5]
Student's First and Last Name	[6]
Student's First and Last Name	[7]
Student's First and Last Name	[8]
Student's First and Last Name	[9]
Student's First and Last Name	[10]

Athletic Participation

If you are registering 3 or under use Athletic Participation.
If you are registering 4 or more use Athletic Family Plan.
The maximum costs per family is $300.00

WSGS: Athletic Participation: (6th - 8th grades):

$100.00

Quantity:

Item Subtotal:

$0.00

Student's First and Last Name	[1]
Grade Level	[1]
Student's First and Last Name	[2]
Grade Level	[2]
Student's First and Last Name	[3]
Grade Level	[3]
Student's First and Last Name	[4]
Grade Level	[4]
Student's First and Last Name	[5]
Grade Level	[5]
Student's First and Last Name	[6]
Grade Level	[6]
Student's First and Last Name	[7]
Grade Level	[7]
Student's First and Last Name	[8]
Grade Level	[8]
Student's First and Last Name	[9]
Grade Level	[9]
Student's First and Last Name	[10]
Grade Level	[10]

Albion Grade School

Book Rental

AGS: Early Childhood:

$55.00

Quantity:

Item Subtotal:

$0.00

Student's First and Last Name	[1]
Grade Level	[1]
Student's First and Last Name	[2]
Grade Level	[2]
Student's First and Last Name	[3]
Grade Level	[3]
Student's First and Last Name	[4]
Grade Level	[4]
Student's First and Last Name	[5]
Grade Level	[5]
Student's First and Last Name	[6]
Grade Level	[6]
Student's First and Last Name	[7]
Grade Level	[7]
Student's First and Last Name	[8]
Grade Level	[8]
Student's First and Last Name	[9]
Grade Level	[9]
Student's First and Last Name	[10]
Grade Level	[10]

AGS: Grades K-8:

$65.00

Quantity:

Item Subtotal:

$0.00

Student's First and Last Name	[1]
Grade Level	[1]
Student's First and Last Name	[2]
Grade Level	[2]
Student's First and Last Name	[3]
Grade Level	[3]
Student's First and Last Name	[4]
Grade Level	[4]
Student's First and Last Name	[5]
Grade Level	[5]
Student's First and Last Name	[6]
Grade Level	[6]
Student's First and Last Name	[7]
Grade Level	[7]
Student's First and Last Name	[8]
Grade Level	[8]
Student's First and Last Name	[9]
Grade Level	[9]
Student's First and Last Name	[10]
Grade Level	[10]

AGS: Technology (Grades 6-8):

$20.00

Quantity:

Item Subtotal:

$0.00

Student's First and Last Name	[1]
Student's First and Last Name	[2]
Student's First and Last Name	[3]
Student's First and Last Name	[4]
Student's First and Last Name	[5]
Student's First and Last Name	[6]
Student's First and Last Name	[7]
Student's First and Last Name	[8]
Student's First and Last Name	[9]
Student's First and Last Name	[10]

Athletic Participation

If you are registering 3 or under use Athletic Participation.
If you are registering 4 or more use Athletic Family Plan.
The maximum costs per family is $300.00

AGS: Athletic Participation: (6th - 8th grades):

$100.00

Quantity:

Item Subtotal:

$0.00

Student's First and Last Name	[1]
Grade Level	[1]
Student's First and Last Name	[2]
Grade Level	[2]
Student's First and Last Name	[3]
Grade Level	[3]
Student's First and Last Name	[4]
Grade Level	[4]
Student's First and Last Name	[5]
Grade Level	[5]
Student's First and Last Name	[6]
Grade Level	[6]
Student's First and Last Name	[7]
Grade Level	[7]
Student's First and Last Name	[8]
Grade Level	[8]
Student's First and Last Name	[9]
Grade Level	[9]
Student's First and Last Name	[10]
Grade Level	[10]

Edwards County High School

Book Rental

ECHS: Grades 9-12:

$70.00

Quantity:

Item Subtotal:

$0.00

Student's First and Last Name	[1]
Grade Level	[1]
Student's First and Last Name	[2]
Grade Level	[2]
Student's First and Last Name	[3]
Grade Level	[3]
Student's First and Last Name	[4]
Grade Level	[4]
Student's First and Last Name	[5]
Grade Level	[5]
Student's First and Last Name	[6]
Grade Level	[6]
Student's First and Last Name	[7]
Grade Level	[7]
Student's First and Last Name	[8]
Grade Level	[8]
Student's First and Last Name	[9]
Grade Level	[9]
Student's First and Last Name	[10]
Grade Level	[10]

ECHS: Technology (Grades 9-12):

$20.00

Quantity:

Item Subtotal:

$0.00

Student's First and Last Name	[1]
Student's First and Last Name	[2]
Student's First and Last Name	[3]
Student's First and Last Name	[4]
Student's First and Last Name	[5]
Student's First and Last Name	[6]
Student's First and Last Name	[7]
Student's First and Last Name	[8]
Student's First and Last Name	[9]
Student's First and Last Name	[10]

*Rental of Chromebook Only

ECHS: Technology (Grades 9-12):

$40.00

Quantity:

Item Subtotal:

$0.00

Student's First and Last Name	[1]
Student's First and Last Name	[2]
Student's First and Last Name	[3]
Student's First and Last Name	[4]
Student's First and Last Name	[5]
Student's First and Last Name	[6]
Student's First and Last Name	[7]
Student's First and Last Name	[8]
Student's First and Last Name	[9]
Student's First and Last Name	[10]

*Payment towards purchase of Chromebook

Drivers Education

ECHS: Drivers Education:

$100.00

Quantity:

Item Subtotal:

$0.00

Student's First and Last Name	[1]
Grade Level	[1]
Student's First and Last Name	[2]
Grade Level	[2]
Student's First and Last Name	[3]
Grade Level	[3]
Student's First and Last Name	[4]
Grade Level	[4]
Student's First and Last Name	[5]
Grade Level	[5]
Student's First and Last Name	[6]
Grade Level	[6]
Student's First and Last Name	[7]
Grade Level	[7]
Student's First and Last Name	[8]
Grade Level	[8]
Student's First and Last Name	[9]
Grade Level	[9]
Student's First and Last Name	[10]
Grade Level	[10]

Athletic Participation

If you are registering 3 or under use Athletic Participation.
If you are registering 4 or more use Athletic Family Plan.
The maximum costs per family is $300.00

ECHS: Athletic Participation: (9th - 12th grades):

$100.00

Quantity:

Item Subtotal:

$0.00

Other Fees

Industrial Arts Fee:

$20.00

Quantity:

Item Subtotal:

$0.00

Student's First and Last Name	[1]
Grade Level	[1]
Student's First and Last Name	[2]
Grade Level	[2]
Student's First and Last Name	[3]
Grade Level	[3]
Student's First and Last Name	[4]
Grade Level	[4]
Student's First and Last Name	[5]
Grade Level	[5]
Student's First and Last Name	[6]
Grade Level	[6]
Student's First and Last Name	[7]
Grade Level	[7]
Student's First and Last Name	[8]
Grade Level	[8]
Student's First and Last Name	[9]
Grade Level	[9]
Student's First and Last Name	[10]
Grade Level	[10]

FCC Automotive Technology ($120 Per Semester):

$240.00

Quantity:

Item Subtotal:

$0.00

Student's First and Last Name	[1]
Grade Level	[1]
Student's First and Last Name	[2]
Grade Level	[2]
Student's First and Last Name	[3]
Grade Level	[3]
Student's First and Last Name	[4]
Grade Level	[4]
Student's First and Last Name	[5]
Grade Level	[5]
Student's First and Last Name	[6]
Grade Level	[6]
Student's First and Last Name	[7]
Grade Level	[7]
Student's First and Last Name	[8]
Grade Level	[8]
Student's First and Last Name	[9]
Grade Level	[9]
Student's First and Last Name	[10]
Grade Level	[10]

*If a student does not continue with the Frontier class, fees for the second semester will be refunded in January.

Athletic Family Plan

If you are registering 3 or under use Athletic Participation.
If you are registering 4 or more use Athletic Family Plan.
The maximum costs per family is $300.00

Athletic Family Plan (Over Three Partipants):

$300.00

Select:

Item Subtotal:

$0.00

Number of Family Members Participating:

Quantity:

Student's First and Last Name	[1]
Student's Grade	[1]
School Location		[1]
Student's First and Last Name	[2]
Student's Grade	[2]
School Location		[2]
Student's First and Last Name	[3]
Student's Grade	[3]
School Location		[3]
Student's First and Last Name	[4]
Student's Grade	[4]
School Location		[4]
Student's First and Last Name	[5]
Student's Grade	[5]
School Location		[5]
Student's First and Last Name	[6]
Student's Grade	[6]
School Location		[6]
Student's First and Last Name	[7]
Student's Grade	[7]
School Location		[7]
Student's First and Last Name	[8]
Student's Grade	[8]
School Location		[8]
Student's First and Last Name	[9]
Student's Grade	[9]
School Location		[9]
Student's First and Last Name	[10]
Student's Grade	[10]
School Location		[10]

Total:

$0.00

Payee's Information

First Name:	Last Name:
Address:
Address:
City:	State/Province:	ZIP/Postal Code:
Phone:
Email:

Payment Information

Method of Payment:

Processing Fee Rates:

Cards: 3% plus $0.55 ($1.55 min)
(4.5% for foreign cards)

eCheck (ACH): $0.55

	Update name from Payee'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:
Confirm Account Number:

Credit Card Number:
Expiration Date:	/
Card ID (CVV2/CID) Number:	What is the Card ID?

Cardholder Information (exactly as it appears on your statement)
	Update from Payee's Information
Cardholder's Name:
Billing ZIP/Postal Code:

PLEASE NOTE: Money can be added to a student's breakfast/lunch account by clicking on
Lunch Program found in the Quick Links area at www.edwardscountyschools.org.

Please be aware that payments will reflect on your statement as

Schools 800-764-0844 Clinton UT

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