2021 One-time Payment by Credit Card 2021 One-time Payment by Credit Card Please complete the following information for your payment. If your payment is for summer tuition, please list that it is for summer and the session # (1, 2 or 3). Student Name* First Last Program and Schedule* Toddler Summer Program Early Childhood/Kindergarten Summer Program Elementary Summer Program 2021 Toddler Monthly Tuition 2021 Early Childhood/Kindergarten Monthly Tuition 2021 Elementary Monthly Tuition Other Please select the program and schedule for your payment. If the payment is not for the programs listed below, please select other.Toddler ProgramOne Session for Summer EC/K Half Day + Convenience Fee of 3.2%One Session for Summer Toddler School DayOne Session for Summer Full Care2021-22 One Month Toddler Half Day Tuition2021-22 One Month Toddler Tuition School Day2021-22 One Month Toddler Tuition Full DayEarly Childhood/Kindergarten Program Schedules and TuitionOne Summer Early Childhood/Kindergarten Session Half DayOne Summer Early Childhood/Kindergarten Session School DayOne Summer Early Childhood/Kindergarten Session Full Day2021-22 School Year Half Day Monthly Tuition2021-22 School Year School Day Monthly Tuition2021-22 School Year Full Day Monthly TuitionAM Activity Club Voucher bookPM Activity Club Voucher bookPlease select the program and schedule for which you will be making a payment.Elementary Program Schedules and TuitionOne Summer Elementary Session School DayOne Summer Elementary Session Full Day2021-22 Monthly Lower Elementary School Day tuition2021-22 Monthly Lower Elementary School Day + Activity Club Tuition2021-22 Monthly Upper Elementary School Day Tuition2021-22 Monthly Upper Elementary School Day + Activity Club TuitionAM Activity Club Voucher bookPM Activity Club Voucher bookOther payment Price: $0.00 Please contact the program administrator to add the correct amount below.Total $0.00 Parent Name* First Last Card holder's Email* Cardholder's PhoneReason for payment*Cardholder's Signature*Billing Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Credit Card* American ExpressDiscoverMasterCardVisa Card Number Month010203040506070809101112 Year20242025202620272028202920302031203220332034203520362037203820392040204120422043 Expiration Date Security Code Cardholder Name
