Enrollment Form

PHHS Scrip Program

 

Progam Rules and Guidelines

 
  1. Each family will be provided a unique customer ID number.  This number must appear on all orders you submit to ensure your purchases are accurately recorded.
  2. All certificate orders must be accompanied by a check or money order made payable to PHHS PTO.  Please do not send cash.  Scrip certificate payments are not tax deductible because you receive dollar for dollar value.
  3. If your check is returned because of non-sufficient funds (NSF), you will be charged a $20 fee payable to PHHS PTO.  After two NSF checks are tendered on your account, your scrip ordering privileges will be limited to money order only.
  4. Once each quarter, PHHS PTO will provide a summary of each participating family's purchases.
  5. Scrip certificates are purchased on your behalf, and are not returnable.  
  6. When you pickup your scrip certificates, open your order and verify its accuracy.  Your signature on the Weekly Order Pickup List indicates you have received your order in its entirety.  In the unlikely event you should find a discrepancy in your scrip order, please contact the PHHS PTO Scrip Program coordinator within 7 days.
  7. Scrip certificates are the same as cash, and should be handled accordingly. PHHS PTO will not be responsible for certificates that are lost, stolen or misplaced while in your possession.
  8. You must sign a WAIVER OF RESPONSIBILITY form before certificates will be mailed to you or released with your child.  These forms will be kept on file, and PHHS PTO accepts no responsibility for certificates delivered in this manner.
   
  Yes!  I'm ready to participate in the PHHS PTO Scrip Program
   
 

First Name

 

Last Name

Street Address

 

City

 

State Zip

Phone

 

   
 

I have read and understand the policies and guidelines listed above, and I agree to abide by these policies

    

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Signature Date

                                                                                              

   
   
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