CLC: Credit Card Payment Form
Wheeler Campus
4139 Wheeler St.
Houston, TX 77204
832.842.0500
Payer First Name:
Payer Last Name:
Email:
Phone Number:
(Format Example: 7137777777)
Child's First Name:
Child's Last Name:
Child's Classroom: (Check all that apply)
Infant-Blue Rom
Toddler-Aqua Room
Toddler-Lt. Blue Room
Toddler-Purple Room
PK-Green Room
PK-Lime Room
PK-Orange Room
PK-Red Room
PK-Yellow Room
Other
If Other:
Amount:
--Select Amount--
Student Parent (Infant) $290
Student Parent (Toddler) $240
Student Parent (PK) $200
Staff Parent (Infant) $315
Staff Parent (Toddler) $265
Staff Parent (PK) $225
Faculty Parent (Infant) $320
Faculty Parent (Toddler) $270
Faculty Parent (PK) $230
Alumni Parent (Infant) $330
Alumni Parent (Toddler) $280
Alumni Parent (PK) $240
Enrollment Fee $345
Late Payment Fee $25
Waitlist Fee $45
Other
If Other:
Total Amount (in dollars)
$
.00