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Grade 6 Moose Jaw Band Registration

Please complete the form below. Required fields marked with an asterisk *

Today's Date*

Answer Required

Student's Name*

Answer Required

Parent (Guardian) Name(s)*

Answer Required

Parent/Guardian e-mail*

Answer Required

Parent/Guardian Phone Number*

Number Required

I allow my child’s picture to be shown on the band website.*

Answer Required

Yes

Payments

How would you like to pay?*

Answer Required

Cheque - full amount $110

Credit Card - full amount $110

Cash $110 Payable at the Division Office - 445 - 13th Ave. NE, Moose Jaw

Postdated cheques - $20.00 September 1, 30.00 October 1, November 1 and December 1 (Make cheques payable to HTCSD)

Cheques may be mailed to: Box 427, Moose Jaw, SK S6H 4P1

Grade 6 Band Fees - check this box to pay via credit card.

Price: $110.00

Confirmation Email

Confirmation Email *

Email Required