Kenosha Montessori School

SCRIP Order Form

Parent Name:                                                                     
Date:                                                                  

Phone:                                                                  
Email:                                                                  

Check #                                  

Orders are due weekly by 5:30 PM on Mondays.  Delivery of certificates is anticipated on Fridays at the latest.

1. Please enclose a separate check made out to KMS SCRIP.

2. Keep the complete list of retailers as a shopping guide.

3. To view the list of retailers and any restrictions, go to:  www.shopwithscrip.com

4. If you have an questions, please phone Gloria in the office at 654-6950.

             I Wish to donate all of the profit to Kenosha Montessori School.

             I Wish to have 1/2 of the profit go towards my tuition payment.
 

Retail Store                             Denom.                  %            Qty.             Total