CLC: Credit Card Payment Form - University of Houston

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Wheeler

CLC: Credit Card Payment Form

We only accept Visa and Mastercard payment forms.

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:

If Other:

Total Amount (in dollars)

$

.00

University of Houston
Houston, Texas 77204
(713) 743-2255

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