St. Ursula Scrip Program Permission Slip

Complete this form if you would like your SUA daughter to pick-up your scrip order.  This form is good for the 2009-2010 school year.  Please advise student to protect gift cards as they would guard cash.  SUA cannot be responsible for lost or stolen orders after they leave the office. Student must "sign out" the order when it is picked up from the Main office during school hours on Fridays.

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.