SIPlive: Voyage Academy - Misc Fees (L.?)

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]

Expedition Contribution 2019-2020:

$20.00

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]

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]

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]

Non-Student Lunch Payments

Amount:

Item Subtotal:

$0.00

Name	[1]
Name	[2]
Name	[3]
Name	[4]
Name	[5]
Name	[6]
Name	[7]
Name	[8]
Name	[9]
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)
(4.50% 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:
Confirm 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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