The Cornerstone Christian School 2020-2021 Scrip Enrollment Form MUST BE COMPLETED BEFORE PLACING YOUR FIRST SCRIP ORDER Return it to the school office or scan this form and e-mail it to [email protected] Cornerstone (CCS) sponsors a Scrip program which allows you to purchase Scrip. The Scrip cards you purchase through our program generate rebates from the participating retailers. These rebates can be used as a credit to your tuition account and/or a gift to the school. 1. For administering the Scrip program, The CCS PTFA will retain 50% of the rebates received from your Scrip purchases as a donation. 2. CCS agrees to apply the remaining 50% balance of your rebates as designated below. Please mark ONE option. a. _________ Credited to your tuition account for the 2021-2022 school year* b. _________ Credited to the tuition account of ________________________(family name) for the 2021-2022 school year* c. _________ Credited as an additional contribution to Cornerstone Christian School *In the event that a family does not attend CCS for the 2021-2022 school year, the rebate will be donated to the CCS PTFA. Please sign and date below to indicate your acknowledgement of this agreement. Purchaser’s Signature:_______________________________________________________________________ Printed Name:____________________________________________________________________________ Spouse’s Name:____________________________________________________________________________ Student’s Name (s): _________________________________________________________________________ Address:_________________________________________________________ City:_______________________________ Zip:____________ E-mail Address:___________________________________________________________________________ Phone Number:______________________ Date:___________________