Aqui Scrip Program
 

What is Aqui Scrip?

Scrip is Aqui $10 gift certificates sold to your non-profit group at an 8% discount.

Your group sells the certificates and earns an 8% profit.

Scrip Order & Pick Up

Scrip orders are picked up from the Aqui main office in Willow Glen:

1079 Lincoln Avenue
San Jose, CA 95125

To order Scrip, please complete the form below:

NOTE: fields marked with an asterisk( * ) are required for FIRST TIME orders only. If you have ordered scrip from us in the past, you may ignore the fields marked with an asterisk.


Organization Information
Name of your Organization:
*Address:
*City: *State: *Zip:
*Phone Number: *Tax ID #:
Contact/Pick up Person
Name:
E-mail address:
Phone:
Scrip Amount
Total dollar amount you would like to purchase:
(increments of $10 please)
$
Pickup Date & Time
Pickup Date
 Tuesday, February 7
 Wednesday, February 8
 Thursday, February 9
 Friday, February 10
 Monday, February 13
Pickup Time
 9am - 11am
 2pm - 5pm


Menu and prices subject to change without notice. Prices do not include tax.