SIPlive: Quest Academy

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Quest Academy Charter School

Student Last Name, First Name	Last Name	,	First Name
Student Last Name, First Name

Replacement Badge:

$5.00

Select:

Item Subtotal:

$0.00

Library Fines:

Item Subtotal:

$0.00

Field Trips:

Item Subtotal:

$0.00

Please select the Student's Teacher.

Other:

Item Subtotal:

$0.00

Please Describe this Payment

Junior High Registration Fees

6th Grade Fees

6th Grade Registration:

$115.00

Select:

Item Subtotal:

$0.00

7th Grade Fees

7th Grade Registration:

$135.00

Select:

Item Subtotal:

$0.00

8th Grade Fees

See Aspire Account for amount owed

8th Grade Registration:

Item Subtotal:

$0.00

9th Grade Fees

See Aspire Account for amount owed

9th Grade Registration:

Item Subtotal:

$0.00

*Online Elective Fee:

$35.00

Select:

Item Subtotal:

$0.00

*Only pay if scheduled for this class.

Total:

$0.00

Parent/Guardian Info

First Name:		Last Name:
Phone:
Email:

Please be aware that Card Payments will be described as
"Schools 800-764-0844 Clinton UT" on your statement.

Payment Information:

Processing Fee Rates:
Cards:	3% plus $0.50 ($1.50 min) (4.5% for foreign cards)
eCheck (ACH):	$0.50

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:

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