Student NamePlease tell us the name of the student for which this payment is being made. First Last Tuition or Fee Type*Please select if the type of payment you are making. If you are making multiple types of fee, please select "Multiple Fees" and provide a description. Tuition Late Fee Gym Fee Dance Fee Music Therapy Fee Multiple Fees TuitionPlease tell us the amount of tuition you are paying. Late Fee*Please tell us the amount of the late fee you are paying. Disregard this field if you are not paying a late fee. Gym Fee*Please tell us the amount of the gum fee you are paying. Disregard this field if you are not paying a gym fee. Dance Fee*Please tell us the amount of the dance fee you are paying. Disregard this field if you are not paying a dance fee. Music Therapy Monthly Fee*Music therapy is $40 per month. Disregard this field if you are not paying a music therapy fee. Price: Multiple Fees*If you are paying multiple fees, please tell us the total amount and use the "Multiple Fees" field to tell us the amount of each. Multiple Fee Explanation*Example: I am paying at total of $114. Tuitiion, $104 + Late Fee $10. TotalThis is the total amount of your payment. $0.00 Payor Name*Please provide the name of the person making this payment. First Last Address* Street Address City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code PhonePlease provide a telephone number so we can contact you if additional information is needed.Email*A receipt will be sent to this email address. Email Future Use Consent*Please select "No" if you would not like to receive future email from us. This will not change previous choices if you are currently receiving email from us. Yes No Additional InformationYou may provide additional information regarding this payment.Payment Type* Credit Card PayPal Select this payment method if you want to use your PayPal account. You will be taken to the PayPal website. Please use Credit Card if not using your PayPal account. Credit Card*Card Details Cardholder Name NameThis field is for validation purposes and should be left unchanged.
