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CAP (Catholic After-school Program) Payment

- Parents

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- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
- Email REQUIRED Please fill out this field. Please enter an email address.
- Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Date REQUIRED Please fill out this field. Please enter a date.
- Student(s) Name- REQUIRED Please fill out this field. Please enter valid data.
- CAP Payment Amount REQUIRED $ Please fill out this field. Please enter a positive decimal.
- Electronic Transaction Fee - Required for all online payments - Select your payment method REQUIRED Credit Card Transaction Fee - 3.1% Debit Card Transaction Fee - 1.7% Check Transaction Fee - 1% Please fill out this field.
- I Agree Please select this field.
Total:

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