Wasatch Charter School
             
 
Kindergarten - Supply Contribution:   $120.00   Quantity:   Item Subtotal:  
$0.00
Student's First and Last Name [1]

Student's First and Last Name
[2]
Grade 1 - Supply Contribution:   $120.00   Quantity:   Item Subtotal:  
$0.00
Student's First and Last Name [1]

Student's First and Last Name
[2]
Grade 2 - Supply Contribution:   $120.00   Quantity:   Item Subtotal:  
$0.00
Student's First and Last Name [1]

Student's First and Last Name
[2]

Student's First and Last Name
[3]

Student's First and Last Name
[4]

Student's First and Last Name
[5]

Student's First and Last Name
[6]

Student's First and Last Name
[7]

Student's First and Last Name
[8]

Student's First and Last Name
[9]

Student's First and Last Name
[10]
Grade 3 - Supply Contribution:   $120.00   Quantity:   Item Subtotal:  
$0.00
Student's First and Last Name [1]

Student's First and Last Name
[2]
Grade 4 - Supply Contribution:   $120.00   Quantity:   Item Subtotal:  
$0.00
Student's First and Last Name [1]

Student's First and Last Name
[2]
Grade 5 - Supply Contribution:   $120.00   Quantity:   Item Subtotal:  
$0.00
Student's First and Last Name [1]

Student's First and Last Name
[2]
Grade 6 - Supply Contribution:   $120.00   Quantity:   Item Subtotal:  
$0.00
Student's First and Last Name [1]

Student's First and Last Name
[2]
Grade 7 - Supply Contribution:   $120.00   Quantity:   Item Subtotal:  
$0.00
Student's First and Last Name [1]

Student's First and Last Name
[2]
Grade 8 - Supply Contribution:   $120.00   Quantity:   Item Subtotal:  
$0.00
Student's First and Last Name [1]

Student's First and Last Name
[2]
 
Total:
$0.00

If you are unable to contribute for school supplies,
the items will still be supplied by the school for your student.
 
Parent/Guardian Information
First Name: Last Name:
Address:
Address:
City: State/Province: ZIP/Postal Code:
Phone:
Email:
Payment Information:
Processing Fee Rates:
Cards:3% plus $0.50 ($1.50 min)
(1.5% surcharge for foreign cards)
eCheck:$0.49
Method of Payment:
  Credit/Debit Card
  eCheck
 Update Name from Above
Name on Account:
Routing Number:
Account Number:
Institution:
Name on Card:
Account Number:
Expiration Date:
Billing Street Address:
Billing ZIP/Postal Code:
 Change Payment Method

Your statement will describe your payment as CBT*WASATCH CHARTER

and the service fee transaction as CBT*SVC FEE WASATCH C
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