Voyage Academy - Misc Fees
             
Voyage Academy
801-776-4900


Donations/Contributions
Expedition Contribution 2018-2019:   $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]
 
Classroom Donation - Student 1:   $   Item Subtotal:  
$0.00
Student's First and Last Name [1]
Teacher's Name/Department [1]

Student's First and Last Name

[2]
Teacher's Name/Department [2]

Student's First and Last Name

[3]
Teacher's Name/Department [3]

Student's First and Last Name

[4]
Teacher's Name/Department [4]

Student's First and Last Name

[5]
Teacher's Name/Department [5]

Student's First and Last Name

[6]
Teacher's Name/Department [6]

Student's First and Last Name

[7]
Teacher's Name/Department [7]

Student's First and Last Name

[8]
Teacher's Name/Department [8]

Student's First and Last Name

[9]
Teacher's Name/Department [9]

Student's First and Last Name

[10]
Teacher's Name/Department [10]
Classroom Donation - Student 2:   $   Item Subtotal:  
$0.00
Student's First and Last Name [1]
Teacher's Name/Department [1]

Student's First and Last Name

[2]
Teacher's Name/Department [2]

Student's First and Last Name

[3]
Teacher's Name/Department [3]

Student's First and Last Name

[4]
Teacher's Name/Department [4]

Student's First and Last Name

[5]
Teacher's Name/Department [5]

Student's First and Last Name

[6]
Teacher's Name/Department [6]

Student's First and Last Name

[7]
Teacher's Name/Department [7]

Student's First and Last Name

[8]
Teacher's Name/Department [8]

Student's First and Last Name

[9]
Teacher's Name/Department [9]

Student's First and Last Name

[10]
Teacher's Name/Department [10]
PCO Membership:   $6.00   Select:   Item Subtotal:  
$0.00
 
Library Book Fee:   $   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]
Library Donation:   $   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]
Art Donation:   $   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]
Life Skills Donation:   $   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]
Music Donation:   $   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]
 
Student Council:   $50.00   Quantity:   Item Subtotal:  
$0.00
Student First and Last Name [1]

Student First and Last Name

[2]

Student First and Last Name

[3]

Student First and Last Name

[4]

Student First and Last Name

[5]

Student First and Last Name

[6]

Student First and Last Name

[7]

Student First and Last Name

[8]

Student First and Last Name

[9]

Student First and Last Name

[10]
 

 
Apparel
Polo Shirt:   $18.00   Quantity:   Item Subtotal:  
$0.00
Student's First and Last Name [1]
Polo Shirt Size [1]
Polo Shirt Color [1]

Student's First and Last Name

[2]
Polo Shirt Size [2]
Polo Shirt Color [2]

Student's First and Last Name

[3]
Polo Shirt Size [3]
Polo Shirt Color [3]

Student's First and Last Name

[4]
Polo Shirt Size [4]
Polo Shirt Color [4]

Student's First and Last Name

[5]
Polo Shirt Size [5]
Polo Shirt Color [5]

Student's First and Last Name

[6]
Polo Shirt Size [6]
Polo Shirt Color [6]

Student's First and Last Name

[7]
Polo Shirt Size [7]
Polo Shirt Color [7]

Student's First and Last Name

[8]
Polo Shirt Size [8]
Polo Shirt Color [8]

Student's First and Last Name

[9]
Polo Shirt Size [9]
Polo Shirt Color [9]

Student's First and Last Name

[10]
Polo Shirt Size [10]
Polo Shirt Color [10]
T-Shirt:   $12.00   Quantity:   Item Subtotal:  
$0.00
Student's First and Last Name [1]
T-Shirt Size [1]

Student's First and Last Name

[2]
T-Shirt Size [2]

Student's First and Last Name

[3]
T-Shirt Size [3]

Student's First and Last Name

[4]
T-Shirt Size [4]

Student's First and Last Name

[5]
T-Shirt Size [5]

Student's First and Last Name

[6]
T-Shirt Size [6]

Student's First and Last Name

[7]
T-Shirt Size [7]

Student's First and Last Name

[8]
T-Shirt Size [8]

Student's First and Last Name

[9]
T-Shirt Size [9]

Student's First and Last Name

[10]
T-Shirt Size [10]
Small Voyage Decal:   $2.00   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]
Large Voyage Decal:   $3.00   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]
 

 
 

 
Miscellaneous Payments
Other:   $   Item Subtotal:  
$0.00
Please describe this payment [1]
Student or Staff Full Name [1]

Please describe this payment

[2]
Student or Staff Full Name [2]

Please describe this payment

[3]
Student or Staff Full Name [3]

Please describe this payment

[4]
Student or Staff Full Name [4]

Please describe this payment

[5]
Student or Staff Full Name [5]

Please describe this payment

[6]
Student or Staff Full Name [6]

Please describe this payment

[7]
Student or Staff Full Name [7]

Please describe this payment

[8]
Student or Staff Full Name [8]

Please describe this payment

[9]
Student or Staff Full Name [9]

Please describe this payment

[10]
Student or Staff Full Name [10]
 
Total:
$0.00

Payer's Information
First Name: Last Name:
Email:
Payment Information
Method of Payment:
Processing Fees: Credit cards: 3% plus $0.50 ($1.50 min)
                    (+1.5% processing fee for foreign cards)
eChecks: $0.49
Update name from Payer'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:
Credit Card Number: (Type number or swipe with cursor in this empty field)
Expiration Date: /
Card ID (CVV2/CID) Number: What is the Card ID?
Cardholder Information (exactly as it appears on your statement)
  Update from Payer's Information
Cardholder's Name:
Billing ZIP/Postal Code:

Please be aware that payments will reflect on your statement as

Schools 800-764-0844 Clinton UT

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