Arizona ESA · ClassWallet

CIP membership for ESA families.

Families using Arizona ESA funds follow a slightly different membership and payment process. Please complete this form so we can prepare accurate invoices for each participating student and provide the information needed for submission through ClassWallet.

Parent / guardian full legal name

Name of ESA account holder, if different

Email address associated with ClassWallet

Preferred email for CIP communications

Can be the same as your ClassWallet email

Phone

Have you previously used ClassWallet to pay an approved vendor?

YesNo

Would you like help with the ClassWallet submission process?

YesNoMaybe

I confirm that all student names have been entered exactly as they appear on their ESA/ClassWallet accounts.I understand that completing this form begins the CIP ESA membership process but does not guarantee placement until registration requirements are completed and membership is confirmed.I understand that I am responsible for submitting the invoice through ClassWallet and monitoring its approval status.I agree to notify CIP if ClassWallet requests changes, additional documentation, or denies the submitted purchase.I understand that any portion not approved or paid through ESA remains the responsibility of the parent or guardian.I confirm that the information provided is accurate.