Pay Fees – Kalamazoo Junior Symphony Orchestra

Product Name

Select Applicable Fee Amount

Other Fee Amount (describe in the comments box)

Tax Deductible Donation (to be credited to your family fundraising account)

Total

$0.00

Name of Student 1*

First Last

Student 1 Ensemble

Name of Student 2

First Last

Student 2 Ensemble

Name of Student 3

First Last

Student 3 Ensemble

Comments

Credit Card Information

American Express

Discover

MasterCard

Visa

Card Number Expiration Date Security Code Cardholder Name

Email (where you would like your receipt to be sent)*

Name of Person Submitting Form*

First Last