2017-2018 Sacred Heart School Preschool/Jr. Kindergarten Tuition Payment Agreement Instructions: Please fill out only the front OR the back side—whichever corresponds with your payment preference.

Cash Option Mother’s Name___________________________________________________________ Mother’s Address_________________________________________________________ Father’s Name____________________________________________________________ Father’s Address__________________________________________________________ Student Name_______________________________Grade___________ Student Name_______________________________Grade___________ Student Name_______________________________Grade___________ Student Name_______________________________Grade___________ Preschool/Jr. Kindergarten Tuition Rates for 2017-2018 – Cash Option Two Day Session $ 840.00 Three Day Session $ 980.00 Half Day Jr. Kindergarten $1310.00 Full Day Jr. Kindergarten $2620.00 Total tuition due for my/our Preschool/Jr. Kindergarten family members:_____________ Please check preferred payment option/method. (Other arrangements may be made by stopping in the school office to discuss your particular needs.)

1.  One cash or check payment due on Sept. 1, 2017 2.  Two cash or check payments due on Sept. 1, 2017 and Jan. 10, 2018 3.  Twelve auto-pay bank withdrawals (July thru June)   

Check your choice for auto-pay withdrawal date 1st , 10th , or 20th of each month OR half on 1st & half on 20th A voided check must be attached to this tuition agreement If no check is attached this agreement will automatically default to number 2

_____________________________________________ Name of responsible billing party _____________________________________________ Signature

____________________________ Date

______________________________________________________________________________________ Complete Billing Address

____________________________________________

________________________

Principal’s Signature

Date

A copy of this agreement with all signatures will be sent to the above billing address.

(OVER)

2017-2018 Sacred Heart School Preschool/Jr. Kindergarten Tuition Payment Agreement Instructions: Please fill out only the front OR the back side—whichever corresponds with your payment preference.

Credit Card Option

(including a 3% bank charge)

Mother’s Name___________________________________________________________ Mother’s Address_________________________________________________________ Father’s Name____________________________________________________________ Father’s Address__________________________________________________________ Student Name_______________________________Grade___________ Student Name_______________________________Grade___________ Student Name_______________________________Grade___________ Student Name_______________________________Grade___________ Preschool/Jr. KindergartenTuition Rates for 2017-2018 – Credit Card Option Two Day Session $ 865.20 Three Day Session $1009.40 Half Day Jr. Kindergarten $1349.30 Full Day Jr. Kindergarten $2698.60 Total tuition due for our Preschool/Jr. Kindergarten family members:________________ Please check preferred payment option/method. (Other arrangements may be made by stopping in the school office.) 1.  One credit card charge on Sept. 10, 2017 2.  Two credit card charges on Sept. 10, 2017 and Jan. 10, 2018 3.  Twelve credit card charges each on the 10th of the month (July thru June) Circle one: Visa MasterCard _____________________________________________________________________________________ Name on Card __________________________________________________ Credit Card Number Security code

_______________________ Expiration Date

__________________________________________________ Signature

_______________________ Date

______________________________________________________________________________________ Complete Billing Address

____________________________________________

________________________

Principal’s Signature

Date

A copy of this agreement with all signatures will be sent to the above billing address .

(OVER)