SA Independence Jr. High/Elem EV
             
Independence Jr. High Campus Registration

Student's Full NameLast Name,First Name
 
Jr. High Registration Fees:   $75.00   Quantity:   Item Subtotal:  
$0.00
Yearbook:   $30.00   Quantity:   Item Subtotal:  
$0.00
 
Total:
$0.00

Parent/Guardian Information
First Name: Last Name:
Phone:
Email:

Please be aware that payments will reflect on your statement as

CBT*SUMMIT ACADEMY and the service fee as CBT*SVC FEE SUMMIT A.

Payment Information:
Processing Fee Rates:
Cards:3% plus $0.50 ($1.50 min)
(1.5% surcharge for foreign cards)
eCheck:$0.49
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:
 Change Payment Method
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