XDC Extra Hours Order Form, 2026-27

XDC Extra Hours Order Form

Month Ordering For(Required)

Student Name(Required)

First Last

Grade/Teacher(Required)

C Days (Full, $68.13) – Number of C Days for this month.

Price: $68.13

D Days (Half, $34.06) – Number of D Days for this month.

Price: $34.06

Total (Extra hours will be billed through FinalSite.)

Total Extra Days (for this month. Add C Days and D Days to get total.)(Required)

List All C Day dates you are ordering for this month. (Enter NA if you are not ordering any C Days for this months.)(Required)

List All D Day dates you are ordering for this month. (Enter NA if you are not ordering any D Days for this months.)(Required)

Parent Name(Required)

First Last

Parent Email(Required)

Signature(Required)

By entering my name above, I agree to the terms and conditions of ordering XDC Extra Hours..