Syracuse Arts Academy - Antelope Fees

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Syracuse Arts Academy Elementary

Student's Name	First		Last
Student's Name

Field Trip:

Item Subtotal:

$0.00

Fine:

Item Subtotal:

$0.00

Library Fine:

Item Subtotal:

$0.00

Total:

$0.00

Payer's Information

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

Payment Information:

Processing Fee Rates:
Cards:	3% ($1.50 min) (1.5% additional service fee for foreign cards)
eCheck:	$0.49

Method of Payment:	Credit/Debit Card eCheck
Update Name from Above

Name on Account:
Routing Number:
Account Number:
Institution:

Name on Card:
Account Number:
Expiration Date:
Billing Street Address:
Billing ZIP/Postal Code:

Payment method will be collected on external device

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Your statement will describe your payment as CBT*SYRACUSEARTSACADE

and the service fee transaction as CBT*SVC FEE SYRACUSEA

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