Student Information
Student Name
*
First Name
Last Name
Grade
*
Please Select
Preschool
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
11th Grade
12th Grade
Parent/Guardian Information
Parent / Guardian Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
Payment Disbursements
Please enter the amounts that you’d like to apply to each category.
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Tuition
$
1.00
Amount ($)
Registration Fee
$
1.00
Amount ($)
Sports Fee
$
1.00
Amount ($)
Spirit Pack
$
1.00
Amount ($)
Student Activity Fee
$
1.00
Amount ($)
Books
$
1.00
Amount ($)
Other
$
1.00
Amount ($)
Subtotal
$
0.00
Tax
$
0.00
Shipping
$
0.00
Total
$
0.00
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Comment
Signature
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Calvary Baptist Church And School | 2990 Damien Ave, La Verne, CA 91750 | 909-593-4672
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