Robinson Crew Booster Club
RETAIL SCRIP ORDER FORM

Place your order by the 1st of each month-Scrip will be available for pick-up by the 10th

Rower Name: ___________________ Date___/___/___

Buyer Name: ___________________ Check #________

Buyer Phone: ___________________

Buyer E-mail: ___________________

Merchant

Denomination

Quantity

TOTAL:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Checks should be made out to RCBC and include the rowers name

Grand Total $_______

* Note: Go online to www.glscrip.com for a list of participating merchants, their usage guidelines and available denominations.

Note: Robinson Crew will not be accepting orders for merchants who contribute less than 4%

Mail order form and checks made payable to RCBC to:
Carolyn Rathburn, 11906 Cub Ct., Fairfax Station   22039
Questions:

Scrip will be available for pickup after the 10th of the month from :
Jane Dunfee, 4918 Gadsen Drive, Fairfax, VA 22032
Questions: jdunfee4@yahoo.com or 703-426-1579