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SCRIP Courier Consent Form for FVL
Please direct any questions to the FVL SCRIP Office

Courier / Student Information

Please list the FIRST AND LAST names of your designated SCRIP Courier(s)

Click the + to add more names.

SCRIP Account Holder Consent

This document is being submitted by the account-holder and is the person whose electronic signature is above. *
This document must be submitted by the account-holder. If you are not the account-holder, this document is invalid and will not be honored.

Comments or Questions?