Lakeview Academy - Misc. Fees
             
 
Payer's Information
First Name: Last Name:
Address:
Address:
City: State/Province: ZIP/Postal Code:
Phone: Email:
 
 
Middle School Fees
Middle School:   $150.00   Quantity:   Item Subtotal:  
$0.00
Student's Name [1]
Grade [1]

Student's Name

[2]
Grade [2]

Student's Name

[3]
Grade [3]

Student's Name

[4]
Grade [4]

Student's Name

[5]
Grade [5]

Student's Name

[6]
Grade [6]

Student's Name

[7]
Grade [7]

Student's Name

[8]
Grade [8]

Student's Name

[9]
Grade [9]

Student's Name

[10]
Grade [10]
(Total for school year is $150.00)
Drama
Spring Drama Club:   $45.00   Quantity:   Item Subtotal:  
$0.00
Student's Full Name [1]
Student's Grade [1]

Student's Full Name

[2]
Student's Grade [2]

Student's Full Name

[3]
Student's Grade [3]

Student's Full Name

[4]
Student's Grade [4]

Student's Full Name

[5]
Student's Grade [5]
 
Camp Fees
9th Grade Camp Fee:   $40.00   Quantity:   Item Subtotal:  
$0.00
Student's Full Name [1]

Student's Full Name

[2]

Student's Full Name

[3]

Student's Full Name

[4]

Student's Full Name

[5]

Student's Full Name

[6]

Student's Full Name

[7]

Student's Full Name

[8]

Student's Full Name

[9]

Student's Full Name

[10]
 
Soccer
Soccer:   $60.00   Quantity:   Item Subtotal:  
$0.00
Student's Name [1]

Student's Name

[2]

Student's Name

[3]

Student's Name

[4]

Student's Name

[5]

Student's Name

[6]

Student's Name

[7]

Student's Name

[8]

Student's Name

[9]

Student's Name

[10]
 
BCI - (Appointment with the front desk required before payment)
Employee/Volunteer Background:   $37.00   Quantity:   Item Subtotal:  
$0.00
Name [1]

Name

[2]

Name

[3]

Name

[4]

Name

[5]

Name

[6]

Name

[7]

Name

[8]

Name

[9]

Name

[10]
Outside Fingerprinting:   $20.00   Quantity:   Item Subtotal:  
$0.00
 
Student Supply Donation
K-6 Donation:   $15.00   Quantity:   Item Subtotal:  
$0.00
Student's Name [1]
Student's Grade [1]

Student's Name

[2]
Student's Grade [2]

Student's Name

[3]
Student's Grade [3]

Student's Name

[4]
Student's Grade [4]

Student's Name

[5]
Student's Grade [5]

Student's Name

[6]
Student's Grade [6]

Student's Name

[7]
Student's Grade [7]

Student's Name

[8]
Student's Grade [8]

Student's Name

[9]
Student's Grade [9]

Student's Name

[10]
Student's Grade [10]
 
Total:
$0.00

Payment Information
Method of Payment:
Convenience Fees: Credit cards: 3% plus $0.50 ($1.50 min)
                    (+1.5% convenience for foreign cards)
eChecks: $0.49
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:
Credit Card Number: (Type number or swipe with cursor in this empty field)
Expiration Date: /
Card ID (CVV2/CID) Number: What is the Card ID?
Cardholder Information (exactly as it appears on your statement)
  Update from Payer's Information
Cardholder's Name:
Billing ZIP/Postal Code:

Please be aware that payments will reflect on your statement as

Schools 800-764-0844 Clinton UT

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