UT Success Academy

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UT Success Academy Fee Schedule
School fees MUST be paid prior to the start of school

Student's First and Last Name	First Name	,	Last Name
Student's First and Last Name

HOSA Leadership Competition:

$50.00

Select:

Item Subtotal:

$0.00

NHS Awards Dinner:

$15.00

Quantity:

Item Subtotal:

$0.00

Student Council Jacket:

$55.27

Quantity:

Item Subtotal:

$0.00

Science Poster:

$10.00

Quantity:

Item Subtotal:

$0.00

Total:

$0.00

Parent/Guardian Information

First Name:	Last Name:
Address:
Address:
City:	State/Province:	ZIP/Postal Code:
Phone:
Email:

Your statement will describe your payment as CBT*SUCCESS ACADEMY

and the service fee transaction as CBT*SVC FEE SUCCESS ACAD

Student's First and Last Name is required
Student's First and Last Name is required
First Name: is required
Last Name: is required
Address: is required
City: is required
State/Province: is required
ZIP/Postal Code: is required
Phone: is required
Email: is required


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