Lakeview Academy - Misc. Fees
             
Lakeview Academy Jog-A-Thon
 
 
Donation Amount for Student 1:   $   Item Subtotal:  
$0.00
Student's Full Name [1]

Student's Full Name

[2]

Student's Full Name

[3]

Student's Full Name

[4]

Student's Full Name

[5]

Student's Full Name

[6]

Student's Full Name

[7]

Student's Full Name

[8]

Student's Full Name

[9]

Student's Full Name

[10]
Donation Amount for Student 2:   $   Item Subtotal:  
$0.00
Student's Full Name [1]

Student's Full Name

[2]

Student's Full Name

[3]

Student's Full Name

[4]

Student's Full Name

[5]

Student's Full Name

[6]

Student's Full Name

[7]

Student's Full Name

[8]

Student's Full Name

[9]

Student's Full Name

[10]
Donation Amount for Student 3:   $   Item Subtotal:  
$0.00
Student's Full Name [1]

Student's Full Name

[2]

Student's Full Name

[3]

Student's Full Name

[4]

Student's Full Name

[5]

Student's Full Name

[6]

Student's Full Name

[7]

Student's Full Name

[8]

Student's Full Name

[9]

Student's Full Name

[10]
 
Total:
$0.00
 
Payer's Information
First Name: Last Name:
Address:
Address:
City: State/Province: ZIP/Postal Code:
Phone: Email:
Payment Information
Method of Payment:
Convenience Fees: Credit cards: 3% plus $0.50 ($1.50 min)
                    (+1.5% convenience for foreign cards)
eChecks: $0.49
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on Checking Account:
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on Savings Account:
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on Checking Account:
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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:

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Schools 800-764-0844 Clinton UT

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