SA Draper Jr. High/Elem

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Student's Full Name	Last Name	,	First Name
Student's Full Name

Jr. High Registration Fees:

$75.00

Quantity:

Item Subtotal:

$0.00

Jr. High Yearbook:

$30.00

Quantity:

Item Subtotal:

$0.00

6th-8th Grade Curricular Fees

Art/Drawing:

$15.00

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Item Subtotal:

$0.00

Fashion Apparel:

$20.00

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Item Subtotal:

$0.00

Field Trip Fee:

Item Subtotal:

$0.00

Foods Class:

$20.00

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Item Subtotal:

$0.00

Forensics Class:

$15.00

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Item Subtotal:

$0.00

Lagoon Fee:

Item Subtotal:

$0.00

Markerspace Class:

$15.00

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Item Subtotal:

$0.00

Mythbusters:

$20.00

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Item Subtotal:

$0.00

Photography:

$15.00

Select:

Item Subtotal:

$0.00

Band/Choir/Orchestra:

Item Subtotal:

$0.00

Choir and Musical Festival:

Item Subtotal:

$0.00

State Honor Choir (by audition only):

Item Subtotal:

$0.00

Hope Squad:

Item Subtotal:

$0.00

Student Council:

Item Subtotal:

$0.00

Extracurricular Activities

HOSA:

$45.00

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Item Subtotal:

$0.00

HOSA Competition:

$50.00

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Item Subtotal:

$0.00

Theater Production:

$25.00

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Item Subtotal:

$0.00

Basketball:

$150.00

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Item Subtotal:

$0.00

Cross Country:

$70.00

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Item Subtotal:

$0.00

Soccer:

$120.00

Select:

Item Subtotal:

$0.00

Volleyball:

$110.00

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Item Subtotal:

$0.00

Athletic Hoodie:

Item Subtotal:

$0.00

Technology

Replacement Screen:

$75.00

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Item Subtotal:

$0.00

Charger:

$25.00

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Item Subtotal:

$0.00

Chromebook Replacement:

$250.00

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Item Subtotal:

$0.00

Non-waivable Fees

FP Shirt T-shirt:

$10.00

Quantity:

Item Subtotal:

$0.00

FP Baseball Hat:

$15.00

Quantity:

Item Subtotal:

$0.00

FP Flat Bill Hat:

$20.00

Quantity:

Item Subtotal:

$0.00

FP Beanie:

$10.00

Quantity:

Item Subtotal:

$0.00

Chromebook Case:

$15.00

Select:

Item Subtotal:

$0.00

Other:

Item Subtotal:

$0.00

Please describe your payment

Total:

$0.00

Parent/Guardain 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.

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Processing Fee Rates:
Cards:	3% plus $0.50 ($1.50 min) (1.5% additional service fee for foreign cards)
eCheck:	$0.50

Method of Payment:	Credit/Debit Card eCheck
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