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Scrip Order

NOTE: Plastic Cards not in stock at CHS will have to be ordered and could take up to 4 weeks for delivery.

Please enter the Card Type (Plastic, ScripNow, ReloadNow), Vendor Name, Amount Needed, and the Denominations to make up that Amount.

Example:  Barnes & Noble  /  $60  /  2 @ $25, 1 @ $10              ($50 + $10 = $60).

If you are reloading a card you already have, please provide the last 4 digits of the card number.

Example: 2 @ $25; 1 @ $10 ; 3 @ $5

Since our percentage can be lower than the credit card fee, please pay the credit card convenience fee. (This will appear on payment page after submitting this form.)

Fri, April 19 2024 11 Nisan 5784