Scholar Academy Fees

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Student's Name & Lunch Number.	Last Name	,	First Name	-	Student # (For help with your Student # call 435-566-6957)
Student's Name & Lunch Number.

Activity Fee (6th Grade):

$25.00

Select:

Item Subtotal:

$0.00

Intro to CCA (7th Grade):

$25.00

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Item Subtotal:

$0.00

Activity Fee (7th Grade):

$25.00

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Item Subtotal:

$0.00

Spanish Fee (7th Grade):

$5.00

Select:

Item Subtotal:

$0.00

Science Fee (7th Grade):

$10.00

Select:

Item Subtotal:

$0.00

Math Calculator (7th Grade):

$5.00

Select:

Item Subtotal:

$0.00

Activity Fee (8th Grade):

$25.00

Select:

Item Subtotal:

$0.00

Spanish Fee (8th Grade):

$5.00

Select:

Item Subtotal:

$0.00

Science Fee (8th Grade):

$10.00

Select:

Item Subtotal:

$0.00

Math Calculator (8th Grade):

$5.00

Select:

Item Subtotal:

$0.00

Teton Science Trip

$400 Paid in full

Partial Payment OPTION Available check aspire for balance owed

*Optional* Teton Science Trip (8th Grade):

Item Subtotal:

$0.00

Art:

$20.00

Select:

Item Subtotal:

$0.00

Choir:

$30.00

Select:

Item Subtotal:

$0.00

Technology Elective:

$10.00

Select:

Item Subtotal:

$0.00

Theatre:

$15.00

Select:

Item Subtotal:

$0.00

Sports After School fee:

Item Subtotal:

$0.00

FACS Exploration Class:

$25.00

Select:

Item Subtotal:

$0.00

Robotics:

$25.00

Select:

Item Subtotal:

$0.00

Total:

$0.00

Personal Information:

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

Payment Information:

Processing Fee Rates:
Cards:	3% plus $0.50 ($1.50 min) (1.5% additional service fee for foreign cards)
eCheck:	$0.49

Method of Payment:	Credit/Debit Card eCheck
Update Name from Above

Name on Account:
Routing Number:
Account Number:
Institution:

Name on Card:
Account Number:
Expiration Date:
Billing Street Address:
Billing ZIP/Postal Code:

Payment method will be collected on external device

Change Payment Method

Your statement will describe your payment as

‘CBT*SCHOLAR ACADEMY’ and the service fee transaction as ‘CBT*SVC FEE SCHOLAR A’

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