Field Trip/Special Event Payment Form

This form is specifically for parents/guardians to make payments towards field trips and/or special events.

Please do not use this form unless directed to do so by faculty or staff.

"*" indicates required fields

Student Name*

First Last

Parent Name*

First Last

Email*

Grade*

Preschool

Kindergarten

Grade 1

Grade 2

Grade 3

Grade 4

Grade 5

Grade 6

Grade 7

Grade 8

Teacher*

This payment is for:*

Field Trip

Special Event

Name and Date (mm/dd/yy) of Field Trip/Special Event*

Payment Amount*

Credit Card field will show AFTER you enter an amount in the “Payment Amount” box.

Fees (30¢ + 2.2%)

Price: $0.00

Total

Credit Card*

Billing Address*

Street Address Address Line 2 City State ZIP Code

Please note: Your Zip Code must match your credit card billing Zip Code or your transaction will not go through.