SACRED HEART SCHOOL – 360 W. WORKMAN ST. COVINA, CA 91723

FAMILY NAME __________________________________________

CHILD’S NAME _____________________ GRADE ______________

Tuition       Cash     Check# __________       Amount ________

Fund. Req.    Cash     Check# ___________       Amount ________

Day Care      Cash     Check# ___________       Amount ________

   Month __________________  Date _________    Total __________

Late fee $25.00 per each category
Return check fee $15/$25 included

SACRED HEART SCHOOL – 360 W. WORKMAN ST. COVINA, CA 91723

FAMILY NAME __________________________________________

CHILD’S NAME _____________________ GRADE ______________

Tuition       Cash     Check# __________       Amount ________

Fund. Req.    Cash     Check# ___________       Amount ________

Day Care      Cash     Check# ___________       Amount ________

   Month __________________  Date _________    Total ___________
Late fee $25.00 per each category
Return check fee $15/$25 included