SCRIP Program Registration

SCRIP Program Registration

Program 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 SCRIP orders must be accompanied by a check or money order made payable to Albany Christian School (ACS). Please do not send cash. SCRIP certificate payments are not tax deductible because you receive dollar for dollar value.
3. If you check is returned because of non-sufficient funds (NFS), you will be charged a $20 fee payable to ACS. After two NSF checks are tendered on your account, your SCRIP ordering privileges will be limited to money order only.
4. Once each quarter, ACS 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 pick up your 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 ACS SCRIP Program Coordinator within 7 days.
7. SCRIP certificates are the same as cash, and should be handled accordingly. ACS 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 ACS accepts no responsibility for certificates delivered in this manner.

Registration Form
To begin participating in the Albany Christian School SCRIP Program,
complete the information below:

	First Name:
	Last Name:
	Spouse's Name:
	Student's Name:

	Street Address:
	City, State, Zip:

	Phone Number:
	E-Mail Address:


	Friends of ACS: Those without students at ACS may also participate in the SCRIP Program. Earnings can be designated for a particular family or as a general contribution:
	Family of: ACS General Contribution N/A I would like to keep my donation confidential.

	Future Families of ACS: Please complete the information below if your child is not yet a student at ACS:
	Projected Date of Enrollment: ACS PreSchool ACS Elementary K-8 N/A

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

Member School

420 Third Avenue SE, Albany, Oregon 97321
541-928-1110

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