SIPlive: Utah Career Path High (L.?)

Career Path High Credit Recovery Fees

2016-17 School Year

Student

Credit Recovery:

$40.00

Quantity:

Item Subtotal:

$40.00

Credit Recovery Terms and Conditions

I agree and acknowledge

By submitting this form I agree to the Credit Recovery Terms and Conditions.

Total:

$40.00

Payee's 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)
(+1.5% processing fee for foreign cards)
eChecks: $0.49

	Update name from Payee'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:
Expiration Date:	/
Card ID (CVV2/CID) Number:	What is the Card ID?

Cardholder Information (exactly as it appears on your statement)
	Update from Payee's Information
Cardholder's Name:

Billing ZIP/Postal Code:

Please be aware that Card Payments will describe this
transaction as Schools 800-764-0844 Clinton UT

Signature/Acknowledment

We (Parent/Guardian) acknowledge, fully understand and agree that: (1) Fees are not refundable, in part or in full, if a student withdraws from Career Path High after the start of the school year. (Fees are for items that have already been purchased per student, such as user licenses for various applications, student laptop, and ID card.) (2) All students are responsible to pay for any loss, breakage or damage they cause. Loss, breakage or damage is not subject to the waiver requirements. Official transcript may be withheld if breakage or damage costs are not paid as outlined in UCA Â§ 53A-11-806.


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