PRATTVILLE CHRISTIAN ACADEMY 2017-2018 TUITION AND FEES CONTRACT Complete the following information: Student Name(s) and Grade(s)(please print): 1)___________________________________Gr_______ 3)______________________________Gr_______ 2)___________________________________Gr_______ 4)______________________________Gr_______ Person responsible for payment (please print):__________________________________________________

PAYMENT DATE Please select your payment date (see Draft Authorization Form for more information): _____5th of the month _____18th of the month

TUITION AND ANNUAL STUDENT FEES PAYMENT OPTIONS ____Lump Sum Payment - $100.00 per student discount if tuition and all fees are paid on or before June 5 or 19, 2017. ____Semi-Annual Payment – first payment is due no later than June 5 or 19, 2017 and the second payment is due no later than December 5 or 18, 2017. ____12 Monthly Payments – first payment is drafted on June 5 or 19, 2017 and last payment is drafted on May 7 or 18, 2018.

OTHER PAYMENT TERMS Please READ each item and initial below: ____The payment option that you select may not be changed after this contract is signed and turned in to the Business Office. However, you may pay more than owed at any time. ____Regardless of payment option selected, outstanding charges, including cafeteria charges, field trips, etc. will be drafted each month, June 2017-June 2018, from my bank account per my Draft Authorization Form. ____There will be a $50.00 fee assessed for any payment that is returned for any reason. ____The family account must be current at the end of first semester in order for the student(s) to return for second semester. ____In the case of early withdrawal during or before the first semester, all annual student fees and one semester of tuition must be paid in full. In the case of early withdrawal after first semester, tuition will be prorated based on the number of days the student was enrolled, and all annual student fees must be paid in full. ____Prattville Christian Academy will not release transcripts, grades, standardized tests, or report cards until the account is paid in full. I have carefully read this payment contract, and I agree to abide by the terms of the payment option that I have chosen. __________________________________________________ __________________________ Signature of person responsible for payment Date

Please complete and return this form to the Business Office no later than March 15, 2017. Family ID_________________________ Pmt. Plan Created__________________ Approved_________________________ W/D_____________________________

PRATTVILLE CHRISTIAN ACADEMY DRAFT AUTHORIZATION FORM Student Name(s)(please print):_______________________________________________________________ Grade(s):_________________________________________________________________________________ Please select: ______I authorize Prattville Christian Academy to continue using the banking information currently on file. Payments will be processed per my signed 2017-2018 Tuition and Fees Contract. ______I am providing updated banking information below for processing payments per my signed 2017-2018 Tuition and Fees Contract.

Name of Customer per bank records (please print):____________________________________________________ Name of Bank __________________________________________________________________________________ Bank Routing Number____________________________________________________________________________ Bank Account Number ___________________________________________________________________________ **Please provide a voided check or copy of check**

I give authority to the above bank to honor preauthorized checks (ACH drafts) drawn by Prattville Christian Academy on my account for the agreed payments in accordance with my 2017-2018 Tuition and Fees Contract. It is understood that Prattville Christian Academy is sending a preauthorized check (ACH draft) to the bank as a payment becomes due. When the bank honors the check by charging my account, such check shall constitute my receipt for the payment. Should any preauthorized check (ACH draft) not be honored by my bank, I understand that I am responsible for that payment plus a service charge of $50.00 (in addition to any service fee that my bank may charge), and that service charge will be added to my PCA account balance. Prattville Christian Academy will draft the monthly tuition, fees and other charges pursuant to my Tuition and Fees Contract on the 5th or 18th of each month beginning June 2017 and ending June 2018. If the 5th or 18th day of the month is weekend day or holiday, the draft will occur on the following business day. The amount to be drafted will be the amount on the monthly statement that is posted online and/or emailed to me on or before the 1st day of each month. I understand that if I wish to terminate this agreement, I will give Prattville Christian Academy a 30 day written notice.

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Signature of Bank Depositor (as shown on bank records)

Date

Please complete and return this form, along with your Tuition and Fees Contract, to the Business Office no later than March 15, 2017. Family ID

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Payment Schedule _______________ Approved ______________________