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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.)

Wed, April 1 2020 7 Nisan 5780