CLASS OF 2017
Prom Package Payment Plan Agreement

Student Name (print) __________________________________________________ ID #__________________

Prom - Saturday, May 20, 2017 @ Sweetwater Country Club - 8:00 p.m.

Trip  - Fiesta Texas - Tuesday, May 30,2017 (Tentative: departs KHS 6:30 a.m. - returns KHS 9:00 p.m.)

              Make payment(s) or pay in full on-line @ KHS Web Store, select Prom OR go to   				 		                    https://fortbendisd.revtrak.net/tek9.asp?pg=KHS 

							
							
		O P T I O N S		(√ )			
	PACKAGE 1	- PROM & TRIP (not available after 1/27/17)	$180.00				
							
	PACKAGE 2	- INCLUDES PKG 1 + DATE TICKET (not available after 1/27/17)	$245.00				
	DATE’S NAME _________________________________________					

	PACKAGE 3	- PROM  (Single Ticket) (not available after 1/27/17)	$65.00				
							
	Prom Plus Date Only	_ Prom + 1 Date Ticket (not available after 1/27/17)	$130.00				

	INDIVIDUAL SENIOR TRIP Ticket ( (not available after 1/27/17)	$115.00				

					Payment Schedule
Payment Due Date	Package 1	Package 2	Package 3	Prom Plus Date Only	Senior Trip Only	
September  29, 2016	$100.00	$125.00	$25.00	$50.00	$45.00	
October 21, 2016	$40.00	$60.00	$20.00	$40.00	$35.00	
November 18th, 2016	$40.00	$60.00	$20.00	$40.00	$35.00	
DISCOUNTS for package purchasing and payment plans end January 27, 2017.
Beginning February 30, 2017, only Prom Tickets will be available for purchase (and not until May!).

By signing below, I understand that...
•	I am responsible for payment of the item(s) selected above on the dates listed. 
•	I may pay for the package in full at any time prior to January 27, 2017. 
•	Failure to make timely payments will result in forfeiture of any and all payments. 
•	Unpaid balances will be added to the Fines List. 
•	I must be clear of all fines to attend Prom and Fiesta Texas trip. 
•	Prom date sheet must be completed in May. 
•	No refunds will be issued if I cannot attend for any reason, including discipline. 

No Refunds!   No Transfers!   No Exchanges!   No Exceptions!

Student Signature ____________________________________________Date _________________________

Parent Signature _________________________________________Date _____________________________

(This form MUST be returned to Barbara Hoffman (Room 621) with signatures.)