Highmark Charter School Fees
             
Highmark Charter School Fees
2017-2018

Student NameFirst Name Last Name
 
Athletics/Activity Fees
Please note that the athletic and activities fees do not include uniforms, camps, or competition fees.
They will be an additional cost depending on the sport or activity.
Athletic Fees:   $   Item Subtotal:  
$0.00
Name of Sport Your Are Paying For [1]

Name of Sport Your Are Paying For

[2]

Name of Sport Your Are Paying For

[3]

Name of Sport Your Are Paying For

[4]

Name of Sport Your Are Paying For

[5]

Name of Sport Your Are Paying For

[6]

Name of Sport Your Are Paying For

[7]

Name of Sport Your Are Paying For

[8]

Name of Sport Your Are Paying For

[9]

Name of Sport Your Are Paying For

[10]
Cheer:   $   Item Subtotal:  
$0.00
Name of Sport Your Are Paying For [1]

Name of Sport Your Are Paying For

[2]

Name of Sport Your Are Paying For

[3]

Name of Sport Your Are Paying For

[4]

Name of Sport Your Are Paying For

[5]

Name of Sport Your Are Paying For

[6]

Name of Sport Your Are Paying For

[7]

Name of Sport Your Are Paying For

[8]

Name of Sport Your Are Paying For

[9]

Name of Sport Your Are Paying For

[10]
Student Government Fee:   $   Item Subtotal:  
$0.00
 
Other Fees
Field Trip:   $   Item Subtotal:  
$0.00
Student's Teacher [1]
Field Trip Location [1]
Student's Grade [1]

Student's Teacher

[2]
Field Trip Location [2]
Student's Grade [2]

Student's Teacher

[3]
Field Trip Location [3]
Student's Grade [3]

Student's Teacher

[4]
Field Trip Location [4]
Student's Grade [4]

Student's Teacher

[5]
Field Trip Location [5]
Student's Grade [5]

Student's Teacher

[6]
Field Trip Location [6]
Student's Grade [6]

Student's Teacher

[7]
Field Trip Location [7]
Student's Grade [7]

Student's Teacher

[8]
Field Trip Location [8]
Student's Grade [8]

Student's Teacher

[9]
Field Trip Location [9]
Student's Grade [9]

Student's Teacher

[10]
Field Trip Location [10]
Student's Grade [10]
Class Schedule Change:   $10.00   Select:   Item Subtotal:  
$0.00
Locker Combo Change:   $5.00   Select:   Item Subtotal:  
$0.00
Clubs:   $10.00   Quantity:   Item Subtotal:  
$0.00
Name of Club [1]

Name of Club

[2]

Name of Club

[3]

Name of Club

[4]

Name of Club

[5]

Name of Club

[6]

Name of Club

[7]

Name of Club

[8]

Name of Club

[9]

Name of Club

[10]
Sports Clinics:   $10.00   Select:   Item Subtotal:  
$0.00
Late Registration Fee:   $10.00   Select:   Item Subtotal:  
$0.00
Library Fine:   $   Item Subtotal:  
$0.00
 
School Donation:   $   Item Subtotal:  
$0.00
Donator's Name [1]
Allocation [1]

Donator's Name

[2]
Allocation [2]

Donator's Name

[3]
Allocation [3]

Donator's Name

[4]
Allocation [4]

Donator's Name

[5]
Allocation [5]

Donator's Name

[6]
Allocation [6]

Donator's Name

[7]
Allocation [7]

Donator's Name

[8]
Allocation [8]

Donator's Name

[9]
Allocation [9]

Donator's Name

[10]
Allocation [10]
Music Donations:   $   Item Subtotal:  
$0.00
Other Fees:   $   Item Subtotal:  
$0.00
Please indication a description for the payment [1]

Please indication a description for the payment

[2]

Please indication a description for the payment

[3]

Please indication a description for the payment

[4]

Please indication a description for the payment

[5]

Please indication a description for the payment

[6]

Please indication a description for the payment

[7]

Please indication a description for the payment

[8]

Please indication a description for the payment

[9]

Please indication a description for the payment

[10]
Total:
$0.00

Parent/Guardian Information
First Name: Last Name:
Address:
Address:
City: State/Province: ZIP/Postal Code:
Phone: Email:
Payment Information
Method of Payment:
Processing Fees: Credit cards: 3% plus $0.50 ($1.50 min)
                    (+1.5% processing fee for foreign cards)
eChecks: $0.49
Update name from Parent/Guardian 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 Parent/Guardian 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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