26-27 K-12 Tuition Form

Parent or Guardian's Full Name

First NameMiddle NameLast Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Contact Number

Area CodePhone Number

E-mail

Enter your tithe paying code

Please request this code from finance@eastgateupc.org

Enter your Lion Scholarship code

This code will be issued after acceptance of Lion Scholarship Application

Number of students you have attending Eastgate Academy:

Please list the names and grades of your students below (e.g., Name - Grade):

How would you like to pay for tuition:

Amount Due: $8,000

Amount Due: $16,000

Amount Due: $24,000

Amount Due: $32,000

Amount Due: $4,500

Amount Due: $8,500

Amount Due: $12,000

Amount Due: $15,500

Amount Due: $4,000 (next payment due January 17th)

Amount Due: $8,000 (next payment due January 17th)

Amount Due: $12,000 (next payment due January 17th)

Amount Due: $16,000 (next payment due January 17th)

Amount Due: $2,250 (next payment due January 17th)

Amount Due: $4,250 (next payment due January 17th)

Amount Due: $6,000 (next payment due January 17th)

Amount Due: $7,750 (next payment due January 17th)

Amount Due: $800 / month

Amount Due: $1,600 / month

Amount Due: $2,400 / month

Amount Due: $3,200 / month

Amount Due: $450 / month

Amount Due: $850 / month

Amount Due: $1200 / month

Amount Due: $1550 / month

Amount Due: $3000

Amount Due: $5,500

Amount Due: $7,500

Amount Due: $9,500

Amount Due: $1,500 (next payment due January 17th)

Amount Due: $2,750 (next payment due January 17th)

Amount Due: $3,750 (next payment due January 17th)

Amount Due: $4,750 (next payment due January 17th)

Amount Due: $300 / month

Amount Due: $550 / month

Amount Due: $750/ month

Amount Due: $950 / month

Tuition Subscription Payment

Enter amount from above

MONTHLY PAYMENTS WILL BE AUTOMATICALLY WITHDRAWN ON THE 17TH DAY OF EACH MONTH.

If your full monthly payment is not received by the 17th of the month there will be a $25 late fee added monthly until the account is up to date.

Annual Book Fees

How would you like to pay book fees?

Annual Technology Fee 5th - 12th Grade

How would you like to pay Technology Fee?

Annual Standardized Testing Fee K-12th Grade

How would you like to pay Testing Fee?

Annual Art Fees

Lunch fees: This $500 fee can be added to your monthly subscription or you can pay in full for the year, however you will not receive a refund no matter how many lunches your child ate throughout the school year. If you choose there will still be the option to purchase lunch cards on the school website.

Annual Lunch Fee K-12th Grade

How would you like to pay Lunch Fees?

If you prefer to opt out of convention fee payments below, you will be required to fundraise and pay the full amount before convention.

Annual High School Convention Fees (subject to increase)

How would you like to pay convention fees?

Additional Fees Total

Enter total additional fees selected above

I authorize the tuition payment to be automatically drafted from my account on a monthly basis beginning in August until my balance has been paid in full.

If you would like to pay any of these fees in full, please enter the correct total amount in the box below, along with your debit card informaiton. Please note that the amount you enter will be withdrawn from your bank account immediately.

If you were approved by TEFA, please make sure you selected that option at the top of this form. You will also have the opportunity to pay any of these fees by cash, card or check at Open House.

Payment Subscription Amount

Payment Amount

USDDescription

Payment Methods

Debit or Credit Card

ACH Bank Transfer

Parent Signature

K-12 Tuition Form

Tuition Information

Additional Fees

Payment Amount