CS Lewis - Fee Payments
Student's Name & ID Number.Last Name,First Name-Student #
Yearbook 2020-2021:   $10.00   Quantity:   Item Subtotal:  
If purchasing more than 1 yearbook,
Please type other student names
Donations:   $   Item Subtotal:  
Bus Fees are $100 for the first student and $50 for each additional student per year.
A Bus Agreement Form will also need to be completed.
Bus Fee:   $   Item Subtotal:  
Parent/Guardian Information
First Name: Last Name:
City: State/Province: ZIP/Postal Code:
Payment Information:
Processing Fee Rates:
Cards:3% plus $0.50 ($1.50 min)
(1.5% surcharge for foreign cards)
Method of Payment:
 Update Name from Personal/Organizational Information
Name on Account:
Routing Number:
Account Number:
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

Your statement will describe your payment as

CBT*CS LEWIS ACADEMY’ and the service fee transaction as ‘CBT*SVC FEE CS LEWIS’

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