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Student Claim Payment
admin
2021-06-04T20:43:03-06:00
NBISD Student Claim Payment
Student Information
Parent First Name
(Required)
Parent Last Name
(Required)
Email
(Required)
Student First Name
(Required)
Student Last Name
(Required)
Student ID Number
(Required)
School
(Required)
Select
Carl Schurz Elementary
County Line Elementary
Klein Road Elementary
Lamar Elementary
Lone Star Early Childhood Center
Memorial Elementary
NB High School
NB Middle School
Ninth Grade Center
Oak Run
School of Choice
Seele Elementary
Veramendi Elementary
Voss Farms Elementary
Walnut Springs Elementary
Grade
(Required)
Pre-K
Kindergarten
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
Item(s) to Replace
Item to Replace
Charging Cord - $17.50
Brick -$17.50
Max Case - $22.00
Keyboard Case - $79.00
Broken iPad - $50.00
Stolen iPad - $50.00
Lost iPad - $100.00
Item to Replace
Screen replacement - $100.00
LCD Replacement - $150.00
Charger Port - $60.00
Headphone Port - $60.00
Home Button - $60.00
Battery - $80.00
Full Replacement - $294.00
Charging Cord
Price:
Brick
Price:
Max Case
Price:
Broken iPad
Price:
Stolen iPad
Price:
Lost iPad
Price:
Keyboard Case
Price:
LCD Replacement
Price:
Charger Port
Price:
Headphone Port
Price:
Home Button
Price:
Battery
Price:
Screen Replacement
Price:
Full Replacement
Price:
And/Or Other Total Paid Not Listed Above
Payment
Total
Credit Card
Card Details
Cardholder Name
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