For Office Use Only-Upward
Students Name
*
Parent's Name
*
Phone Number
*
Your Email Address
*
Please choose which payment you are needing to make. If you are paying for multiple children, click OTHER then type in the box below the amount you are paying.
*
OTHER
Payment 1 (Add $80.00)
Payment 2 (Add $95.00)
If you choose OTHER, please note the amount you are paying here.
$
Total
$
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