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Club and Sports Fees
Student's Full Name
Clubs
4th Grade Ballroom:
$70.00
Quantity:
Item Subtotal:
$0.00
5th and 6th Grade Ballroom:
$150.00
Quantity:
Item Subtotal:
$0.00
Art Club:
$10.00
Quantity:
Item Subtotal:
$0.00
Board Game Club:
$10.00
Quantity:
Item Subtotal:
$0.00
Chess:
$10.00
Quantity:
Item Subtotal:
$0.00
Choir:
$25.00
Quantity:
Item Subtotal:
$0.00
Coding Club:
$20.00
Quantity:
Item Subtotal:
$0.00
Elementary Band:
$50.00
Quantity:
Item Subtotal:
$0.00
Total:
$0.00
Parent/Guardian Info
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):
$0.50
Method of Payment:
Update Name from Personal/Organizational Information
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
Please be aware that payments will reflect on your statement
as
Schools 800-764-0844 Clinton UT
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