Uniform Payments [bt_section][bt_row][bt_column width=”1/1″][bt_text] Uniform Payments Please complete the following form to start your uniform payments. Multiple student families should submit a form for each student. Student Name First Last Select Your Uniform*Harmony Dress (Blue Sequin).Keynote Dress (Red Sequin).Timbre Tots Dress (Red Sequin).Boys Tux (vest, shirt, pants, and bow tie).Payment Options*Pay in FullMonthly PaymentsSequin Dress - KeyNote and Harmony* Price: $141.00 Boys Tux - KeyNote and Harmony* Price: $90.00 Sequin Dress - Timbre Tots* Price: $90.00 I agree to make ten (10) consecutive payments of $15 for my student's dress uniform.*YesI agree to make six (6) consecutive payments of $15 for my student's uniform.YesPayment information:*Please use my billing information already on file.I would like to enter new payment information (requires the first payment of $15.00 to be processed now).First Payment*I authorize the first $15.00 payment to be processed now.I understand that all future payments will be made on the same day as my student's current regular billing cycle.*The transaction will show separately, but will come out on the same day as the regular tuition. YesI agree to this payment schedule, regardless of my student's membership status in the choir.*This is a line of credit that must be paid in full.YesEmail for receipt.* Electronic Signature*Signing below signifies that you agree to the terms shown and options selected above. First Last Credit/Debit Card* American ExpressDiscoverMasterCardVisa Card Number Expiration Date Month010203040506070809101112 Year20212022202320242025202620272028202920302031203220332034203520362037203820392040 Security Code Cardholder Name Total $0.00 CAPTCHA [/bt_text][/bt_column][/bt_row][/bt_section]
