Northside PTO - Electronic Payment Order Form

Name - person making payment *

Payment Items - What is being ordered, paid for, or donated with this online PayPal purchase? *

Please mark all that apply for this electronic payment

Dolphin Dollars

Run Walk Move

Field Trip Chaperone (as needed / TBD this school year)

Other

Required

If indicated Other, what is reason for the electronic payment?

For which student(s) is this payment being made?

Please indicate the name, grade, and teacher for which this payment is being made.