St. Patrick's Summer Program 2020 - St. Patrick Catholic Academy

Stripe Form

If you are human, leave this field blank.

Name of Child Attending Summer Program *

Type of Payment *

Summer Program Fee

Summer Program Early/ Extended Day Fee

Payment Amount

Amount of Fee *

Credit/Debit Card Fee

Amount Charged

Billing Information

Title

First Name *

Last Name *

Address *

Address

City

State/Province

Zip/Postal

Email Address *

Payment Information

Name on Card *

Credit/Debit Card *

Credit/Debit Card

Expiration

Credit/Debit Card

Checkboxes *

Pursuant to the Terms of Use for the Service, I acknowledge that disputes about this payment are determined solely by St. Patrick Catholic Academy. For refund questions, please contact the academy office.

Checkboxes

I'm aware that my information is being collected for marketing purposes. More info