St. Ursula Scrip Program Permission Slip

Complete this form if you would like your SUA daughter to pick-up your scrip order. This form must accompany each and every order you would like picked-up by your daughter.

Name___________________________________________________

SUA daughter’s name_____________________________________

Scrip pick-up date_________________________________________

Phone number and best time to reach you on pick-up date

_______________________________________________________

Please be sure your daughter checks the order for accuracy. If an error is found, please have her discuss with scrip coordinators and if necessary, contact you before removing the order from the bookstore.