Channing Hall Association
of Parents and Students
 
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CHAPS Family Membership (Free Directory Included):   $20.00   Select:   Item Subtotal:  
$0.00
Number of students attending Channing Hall:     Quantity:    
Student's Name [1]
Teacher's Name and Grade [1]

Student's Name
[2]
Teacher's Name and Grade [2]

Student's Name
[3]
Teacher's Name and Grade [3]

Student's Name
[4]
Teacher's Name and Grade [4]

Student's Name
[5]
Teacher's Name and Grade [5]

Student's Name
[6]
Teacher's Name and Grade [6]

Student's Name
[7]
Teacher's Name and Grade [7]

Student's Name
[8]
Teacher's Name and Grade [8]

Student's Name
[9]
Teacher's Name and Grade [9]

Student's Name
[10]
Teacher's Name and Grade [10]
Total:
$0.00
 
Payer's Information
First Name: Last Name:
Address:
Address:
City: State/Province: ZIP/Postal Code:
Phone: Email:
Payment Information
Method of Payment:
Update name from Payer's 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:
Expiration Date: /
Card ID (CVV2/CID) Number: What is the Card ID?
Cardholder Information (exactly as it appears on your statement)
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Cardholder's Name:
Billing Street:
Billing ZIP/Postal Code:
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