SIPlive: Duchesne High School (L.?)

Duchesne High School Registration and Fees

Student Name and ID	Lastname	,	Firstname	-	ID#
Student Name and ID

7th Grade Fees

7th Grade Activities/Locker/Books (Required):

$75.00

Select:

Item Subtotal:

$0.00

7th Grade PE (Required):

$30.00

Select:

Item Subtotal:

$0.00

Yearbook - 7th Grade:

$65.00

Select:

Item Subtotal:

$0.00

Name on Yearbook - 7th Grade:

$7.00

Select:

Item Subtotal:

$0.00

First and Last name as it should appear on your Yearbook

FCCLA:

$20.00

Select:

Item Subtotal:

$0.00

FFA:

$20.00

Select:

Item Subtotal:

$0.00

8th Grade Fees

8th Grade Activities/Locker/Book (Required):

$75.00

Select:

Item Subtotal:

$0.00

8th Grade PE (Required):

$30.00

Select:

Item Subtotal:

$0.00

Yearbook - 8th Grade:

$65.00

Select:

Item Subtotal:

$0.00

Name on Yearbook - 8th Grade:

$7.00

Select:

Item Subtotal:

$0.00

First and Last name as it should appear on your Yearbook

FCCLA:

$20.00

Select:

Item Subtotal:

$0.00

FFA:

$20.00

Select:

Item Subtotal:

$0.00

High School Fees

Activities/Locker/Book (Required):

$75.00

Select:

Item Subtotal:

$0.00

Yearbook - High School:

$65.00

Select:

Item Subtotal:

$0.00

Name on Yearbook - High School:

$7.00

Select:

Item Subtotal:

$0.00

First and Last name as it should appear on your Yearbook

High School Class/Lab Fees

Accounting 1 and 2 (Per Class):

$30.00

Quantity:

Item Subtotal:

$0.00

Ag Mechanics (Per Semester):

$25.00

Quantity:

Item Subtotal:

$0.00

High School Art/Crafts (Per Semester):

$20.00

Quantity:

Item Subtotal:

$0.00

High School Choir/Band (Per Class):

$40.00

Quantity:

Item Subtotal:

$0.00

Driver's Education:

$165.00

Select:

Item Subtotal:

$0.00

Family and Consumer Science (Per Class):

$30.00

Quantity:

Item Subtotal:

$0.00

PE (Required for all PE classes, Per Semester):

$15.00

Quantity:

Item Subtotal:

$0.00

Speech (Per Class):

$15.00

Quantity:

Item Subtotal:

$0.00

Drama (Per Class):

$15.00

Quantity:

Item Subtotal:

$0.00

School Play (Per Play):

$15.00

Quantity:

Item Subtotal:

$0.00

Wood Shop (Per Semester):

$25.00

Quantity:

Item Subtotal:

$0.00

High School Club Fees

FBLA:

$20.00

Select:

Item Subtotal:

$0.00

FCCLA:

$20.00

Select:

Item Subtotal:

$0.00

FFA:

$20.00

Select:

Item Subtotal:

$0.00

Utah High School Activities Association*

(Sports fees are capped at $200 per family. Only check the boxes for sports equal to $200.

The school will distribute the funds to the sport that does not get checked.)

Baseball:

$40.00

Select:

Item Subtotal:

$0.00

Boys Basketball:

$40.00

Select:

Item Subtotal:

$0.00

Cheerleading (Plus Uniform):

$40.00

Select:

Item Subtotal:

$0.00

Cross Country:

$40.00

Select:

Item Subtotal:

$0.00

Drama:

$15.00

Select:

Item Subtotal:

$0.00

Football:

$50.00

Select:

Item Subtotal:

$0.00

Forensics:

$15.00

Select:

Item Subtotal:

$0.00

Girls Basketball:

$40.00

Select:

Item Subtotal:

$0.00

Girls Softball:

$40.00

Select:

Item Subtotal:

$0.00

Girls Volleyball:

$40.00

Select:

Item Subtotal:

$0.00

Golf:

$40.00

Select:

Item Subtotal:

$0.00

Track:

$40.00

Select:

Item Subtotal:

$0.00

Wrestling:

$40.00

Select:

Item Subtotal:

$0.00

Volleyball:

$40.00

Select:

Item Subtotal:

$0.00

Other

Other:

Item Subtotal:

$0.00

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Please describe the purpose of the additional payment.				[10]

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:	(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 Parent/Guardian Information
Cardholder's Name:
Billing ZIP/Postal Code:

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