SIPlive: Delta Middle School (L.?)

Please be aware that payments will reflect on your statement as

Schools 800-764-0844 Clinton UT

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Student Name	Lastname	,	Firstname	-	ID#
Student Name

Lunch Fees

Reduced Lunch Monthly:

$8.00

Select:

Item Subtotal:

$0.00

Reduced Lunch Yearly:

$72.00

Select:

Item Subtotal:

$0.00

Regular Lunch Monthly:

$50.00

Select:

Item Subtotal:

$0.00

Regular Lunch Yearly:

$450.00

Select:

Item Subtotal:

$0.00

Other Lunch Amount:

Item Subtotal:

$0.00

*Applications for free or reduced lunch can be submitted online at

https://www.myschoolapps.com

Grade 6

Writing Fee (Mandatory):

$6.00

Select:

Item Subtotal:

$0.00

Yearbook (Optional):

$17.00

Select:

Item Subtotal:

$0.00

Activity Fee (Optional):

$15.00

Select:

Item Subtotal:

$0.00

Grade 7

Writing Lab (Mandatory):

$6.00

Select:

Item Subtotal:

$0.00

CTE (Mandatory):

$6.00

Select:

Item Subtotal:

$0.00

Fitness (Mandatory):

$15.00

Select:

Item Subtotal:

$0.00

Art:

$5.00

Select:

Item Subtotal:

$0.00

Band:

$15.00

Select:

Item Subtotal:

$0.00

Chorus:

$5.00

Select:

Item Subtotal:

$0.00

Drama/Theatre:

$15.00

Select:

Item Subtotal:

$0.00

Orchestra:

$15.00

Select:

Item Subtotal:

$0.00

Activity Fee (Optional):

$15.00

Select:

Item Subtotal:

$0.00

Yearbook (Optional):

$17.00

Select:

Item Subtotal:

$0.00

Grade 8

Writing Lab (Mandatory):

$6.00

Select:

Item Subtotal:

$0.00

Fitness (Mandatory):

$15.00

Select:

Item Subtotal:

$0.00

Keyboarding (Mandatory):

$3.00

Select:

Item Subtotal:

$0.00

Art:

$5.00

Select:

Item Subtotal:

$0.00

Band:

$15.00

Select:

Item Subtotal:

$0.00

Chorus:

$5.00

Select:

Item Subtotal:

$0.00

Creative Coding/Robotics:

$10.00

Select:

Item Subtotal:

$0.00

Drama/Theatre:

$15.00

Select:

Item Subtotal:

$0.00

Exploring Technology:

$10.00

Select:

Item Subtotal:

$0.00

FACS:

$10.00

Select:

Item Subtotal:

$0.00

Guitar:

$5.00

Select:

Item Subtotal:

$0.00

Orchestra:

$15.00

Select:

Item Subtotal:

$0.00

Activity Fee (Optional):

$15.00

Select:

Item Subtotal:

$0.00

Yearbook (Optional):

$17.00

Select:

Item Subtotal:

$0.00

Total:

$0.00

Parent/Guardian Information

First Name:	Last Name:
Address:
Address:
City:	State/Province:	ZIP/Postal Code:
Phone:	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 Parent/Guardian 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:
Expiration Date:	/
Card ID (CVV2/CID) Number:	What is the Card ID?

Cardholder Information (exactly as it appears on your statement)
	Update from Parent/Guardian Information
Cardholder's Name:
Billing ZIP/Postal Code:

Be Aware that this payment will be posted to the Delta Middle School. If your student is not attending the Delta Middle School, do not pay on this payment page as it will delay your funds being posted to your account. Please use one of the other payment links listed below.

Payment links for other Millard County Schools

Delta South Elementary

Delta North Elementary

Delta High School

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This payment will be posted to Delta Middle School.


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