Student's Name
First Name
Last Name
School Lunch:
$
Item Subtotal:
$0.00
Spring Trip:
$510.00
Select:
Item Subtotal:
$0.00
Yearbook:
$5.00
Select:
Item Subtotal:
$0.00
After School Club:
$
Item Subtotal:
$0.00
School Donation:
$
Item Subtotal:
$0.00
SCA Shirt Orders:
$
Item Subtotal:
$0.00
SCA Fund Raiser:
$
Item Subtotal:
$0.00
SCA School Pictures:
$
Item Subtotal:
$0.00
SCA Green Science Fair:
$
Item Subtotal:
$0.00
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[2]
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[3]
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[4]
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[7]
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[8]
What do you want this to apply to?
[9]
What do you want this to apply to?
[10]
Other Fees:
$
Item Subtotal:
$0.00
Please give a description of what you are paying for
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[2]
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[3]
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[4]
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[8]
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[9]
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[10]
Total:
$0.00
Parent/Guardian Information
First Name:
Last Name:
Phone:
Email:
Payment Information
Processing Fee Rates:
Cards:
3% plus $0.50 ($1.50 min)
(4.5% for foreign cards)
eCheck (ACH):
$0.49
Name on Account:
Routing Number:
Account Number:
Institution:
Name on Card:
Account Number:
Expiration Date:
Billing Street Address:
Billing ZIP/Postal Code:
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