Payment Acknowlegment Form
By utilizing this form, we ensure transparency and accuracy in recording payments, thereby minimizing any potential discrepancies or misunderstandings.
Date of Payment
-
Month
-
Day
Year
Purpose of payment:
*
Class Sampler
Regular School Year Enrollment
Others (Pls. specify details in the box below)
Message
Message
*
For Others, payment could be for: Assessment fees, Uniforms, Field trips, Photos, Videos, Etc..
Please specify No. of children signing up / Name of child(ren) / Levels / Preferred weekly schedule:
*
Example: 1 / John D. Doe / Toddler / 5x
Name of the Payor:
*
First Name
Last Name
Email
*
Confirmation Email
example@example.com
Payment is for:
*
1 Child
2 Children
3 Children
Name of Child 1
*
First Name
Last Name
Child's Level:
*
Toddler
Junior/Senior Casa
Advanced Casa
Payment Plan
*
Annual
Trimestral
Monthly
Name of Child 2
*
First Name
Last Name
Child's Level:
*
Toddler
Junior/Senior Casa
Advanced Casa
Payment Plan
*
Annual
Trimestral
Monthly
Name of Child 3
*
First Name
Last Name
Child's Level:
*
Toddler
Junior/Senior Casa
Advanced Casa
Payment Plan
*
Annual
Trimestral
Monthly
Total amount of payment:
*
Please send us a copy of bank deposit here:
*
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