St. Ursula Scrip Program Permission Slip

Complete this form if you would like your SUA daughter to pick-up your scrip order.  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 Finance Office.

Name___________________________________________________

SUA daughter’s name_______________________________________

Phone Number____________________________________________

Signature_________________________________________________

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 Finance Office.