Enroll Now Welcome to Lourdes!Thank you for choosing to partner with us in your child's education. We are so glad you have chosen to join the Lourdes family. Please complete this form to finish your enrollment process.Name* First Last Phone*Email* New StudentPlease list the child(ren) in your family that will be enrolling at Our Lady of Lourdes School (List oldest child first).Name* First Last Do you have any other children that will be enrolling at Our Lady of Lourdes School?*None1 Additional Child2 Additional Children3 Additional Children4 Additional ChildrenName* First Last Name* First Last Name* First Last Name* First Last CheckoutNew Enrollment Fee (1 Student) Price: New Enrollment Fee (2 Students) Price: New Enrollment Fee (3 Students) Price: New Enrollment Fee (4 Students) Price: New Enrollment Fee (5 Students) Price: Coupon Billing Address Street Address City StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code How would you like to make your payment? Bank Account/ACH Debit/Credit CardTotal Pay by Credit CardAmerican ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Month010203040506070809101112 Year20212022202320242025202620272028202920302031203220332034203520362037203820392040 Expiration Date Security Code Cardholder Name Pay by ACH - Bank Check Account Number SelectSavingsChecking Account Type Routing Number Bank Name Consent I agree to the payment policy below.I authorize the company named on this web form to debit the bank account or credit card indicated in this web form, for the noted amount on today's date. This payment is for the goods and services noted on the web payment form. I understand that returns, refunds and cancellations are not permitted, however exceptions may be made on a case-by-case basis. I understand that because this is an electronic transaction, these funds may be withdrawn from my account as soon as the above noted transaction date. I agree that payments for billing schedules with common bill dates may be consolidated into a single payment. In the case of an ACH Transaction being rejected for Non Sufficient Funds (NSF) I understand that the company named on this web form may at its discretion attempt to process the charge again within 30 days. I acknowledge that the origination of ACH transactions to my account must comply with the provisions of U.S. law. I certify that I am an authorized user of this credit card or bank account, and that I will not dispute the payment with my Credit Card Company or Bank, so long as the transaction corresponds to the terms indicated in this web form.