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Enrollment Forms
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Enrollment Forms

 

Great Lakes Scrip Center wants to help you open your account as quickly as possible. To ensure that there is no delay, please make sure you have completed all of the following steps before submitting your enrollment application:

1. Download your enrollment forms

Print the forms you need as shown below. Fill out the application completely, and be sure to include your organization’s phone number. Missing or incomplete information may delay application processing.

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New Customer Guidebook

Contains an enrollment form, plus detailed information about GLSC customer service policies and procedures.

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One-page enrollment form

Designed for customers who are already familiar with GLSC policies. Click here for html version, or download the pdf version below.

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2. Document your proof of your non-profit status

Great Lakes Scrip Center requires new customers to demonstrate proof of their non-profit status. Most non-profit organizations provide an IRS letter of determination as proof. If an IRS letter of Determination is unavailable, please provide a statement from your non-profit organization’s chief officer on your organization’s letterhead that explains the purpose and goals of your group.

3. Decide how you would like to pay for your orders

ACH Payment

Most GLSC customers choose ACH payment for fast, convenient order processing. When you choose this payment method, GLSC automatically debits your organization’s bank account for your purchases. Just deposit your family’s full face value payment into this account and GLSC will debit the net amount of your order. The resulting balance is your organization’s earnings.

Most GLSC customers set up a separate bank account for their scrip program to simplify bookkeeping.

To select ACH payment, verify your ABA routing number and account number with your bank. Then, complete the ACH authorization portion of the application, and attach a voided or cancelled check. If you choose ACH debit payment, your new account cannot be processed without an actual void or cancelled check from your organization’s bank account.

Pay by Check

Some GLSC customers prefer to pay by check. If you wish to pay by check, please indicate that on your enrollment application. Sorry, but GLSC cannot accept check payments from personal bank accounts. Your check payment must be drawn on an account in the name of your non-profit organization. Also, you need to be aware that GLSC cannot begin processing your order until your check arrives in our offices. Customers who pay by check often find delays are likely since your order will not be processed until GLSC receives payment.

4. Mail the information (do NOT fax) to:

New Customer Coordinator
Great Lakes Scrip Center
PO Box 8158
Kentwood, MI 49518-8158

Your account will be set up within 48 hours of receipt of your enrollment application, and a confirmation letter will be sent to your organization, indicating your account is open.