HOMESCHOOL PAYMENT
Date : _________________ Parents Name : _______________________________________________________________
Address : ________________________________ ___________________________________
( Street Address ) ( City , State , Zip )
Home Telephone : _________________________
Email Address : ________________________________________________________________ Student ’ s Name : __________________________________________
Grade : ___________
Semester : � First
� Second
Registration Fees : An ANNUAL non-refundable $ 40 registration fee per student is required . Course / Activity Title ( s ):
Registration fee ($ 40 x each child )__________ |
Fee : |
$___________ |
_______________________________________ |
Fee : |
$___________ |
_______________________________________ |
Fee : |
$___________ |
_______________________________________ |
Fee : |
$___________ |
Office Use Only
___ Approved ___ Approved ___ Approved
Total Fee : $___________
___ Approved
� cash � check # ______ Total Submitted with Form : _______
Office Use Only ____ Family Interview ( new family / student only ) ____ Business Manager notified ( form and fee ) ____ Athletic Directory notified ( original Athletic / Medial Forms ) ____ Nurse notified ( copy of Athletic / Medical forms ) ____ CCS files updated ( in Elementary office ) Student accepted :
____ Sycamore updated 21 | P a g e
____________________________________________ Tonya Snyder , Principal