JMIC Sunday School 2023-24 Academic Year

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Parent/Guardian

Spouse/Emergency Contact

Waivers

Students

Payment Information

Parent/Guardian Information

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Email *

Confirm Email *

Phone *

First Name *

Last Name *

Address *

City *

State *

Zipcode *

Country *

Household Income Per Year *

Number of people in the household *

I am interested in PTO.

Spouse/Emergency Contact

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Email *

Confirm Email *

First Name *

Last Name *

Phone *

Create a user record for the Portal

Check the box to create a user account for the Spouse/Emergency Contact. They will receive email instructions to access the Portal.

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Waivers

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Code of Conduct

I have read and I agree to the Code of Conduct.

Students Information

(Fields marked with * are required)

Student 1

Name:

Gender:

Date of Birth:


. . .

First Name *

Last Name *

Date of Birth *

Must be 5 years old on September 17th, 2023 and they must not be more than 17 years on September 17th, 2023.

Gender *

Public School Grade *

If you do not see a grade that your child attends, the class for that grade in our school is already full.

T-Shirt Size

Food Allergies

Notes

Payment Information

(Fields marked with * are required)

Payment Plan *

Plan	Amount
Plan A - Full Payment	$
Subtotal	$
Total	$

Payment Details

Secured Online Transaction

Card Number *

Exp. Month *

Exp. Year *

CVC *

Zipcode *

Cardholder Name *

Billing Details

Same as parent address

(Check the box if the billing details are same as parent information)

Email *

Phone Number *

Address *

State *

City *

If you need any further assistance

Contact our support team or Submit an Issue