SCRIP Enrollment – St. Joseph Pewamo

St. Joseph SCRIP Enrollment

This form is to be used to designate which fund you want your earnings to be applied.

Name of person enrolling in the SCRIP Tuition program*

Email*

Daytime Phone:*

Address*

Fund Designation*

100%- All credits accumilated in the program should be credited to the General SCRIP fund.

50% School- 50% of credits will be applied to designated family, remainder will be applied to General SCRIP Fund

50% Faith Formation- 50% of credits will be applied to designated family, remainder will be applied to General SCRIP Fund

50% Technology- 50% of credits will be applied to the Technology Fund, remainder will be applied to General SCRIP Fund

Which student or family account would you like to designate?

Method of Pick Up for SCRIP gift certificates & cards*

I give permission for the student listed below to pick up my SCRIP order via Friday Folders

I will pick up my SCRIP order at the parish office during normal business hours.

I will contact the parish office to make other arrangements.

Student (include grade) who is authorized to pick up SCRIP order

I (We) have read, understand, and will abide by the general policies of the SCRIP program as listed below.*

Yes

Digital Signature- I agree that this agreement ma be electronically signed. Both parties agree that the electronic signatures appearing in this agreement are the same as a handwritten signatures for the purpose of validity, enforceability, and admissibility. Type your full legal name in the space provided.*