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Longfellow Middle School

School Calendar

If you would like to commit to monthly purchases of supermarket scrip and receive monthly reminders from us, use this order form. Please indicate how much scrip you would like to purchase each month. Of course, you can always change your order when you make your monthly purchases.

Name __________________________________________________________________

Mailing Address _________________________________________________________

Telephone Number(s) ____________________________________________________

Monthly Order (supermarket scrip is sold in certificates denominated in $20)

	Number of Certificates	Value of Certificates
Giant
Safeway
Whole Foods
Total

How would you like your supermarket scrip delivered?

Mail them to me _____

Call me to arrange delivery _____

Fill out the form and mail it with check made out to Longfellow PTA for your first monthly purchase to:

Nadja Golding

1942 Rhode Island Avenue

McLean, VAÊ 22101

For more information, contact: