Payment Form - Lakeline

Online Payment Form (Lakeline)

Name*

First Name

Last Name

Address*

Address Line 1

Address Line 2

City

State

ZIP Code

Account Name payment is to be applied to:*

Payment Type:*

Prepay Purchase Balance Due Fulltime Tuition Preschool Tuition After School Pick-up Tuition Camp Deposit Camp Tuition

Other:

Please note: Prepay purchases, tuition, deposits and fees are non-refundable and non-transferable. Prepays must be used within six (6) months of purchase or they expire.

Payment Amount:*

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Billing Information

Total amount to be billed* $

Credit Card*