Reloadable Grocery Card Order Form
Support the Fossil Ridge High School Band by purchasing the groceries you are ALREADY purchasing!! Use the Grocery Card program to make all your purchases at King Soopers and Safeway stores and 5% of your purchase comes back to the Band.

Card orders will be ready for pick-up from the Music Office on Thursday or Friday afternoons

*Please note: Orders submitted after 8:00am on Thursday will be ready for pick-up the following week.

Today's Date: *
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Parent/Guardian Last, First Name: *
Your answer
Student(s) Last, First Name: *
Your answer
Address: *
Your answer
Phone Number: *
Your answer
I wish the proceeds to be applied to (check one)! *
If proceeds are going to a student, please provide the Name Of Student:
Your answer
Payment for cards must be made at either the Fees Window or Online with SchoolPay before receiving cards. Payments ($2.50 per card) will be made... *
How many $2.50 Reloadable King Soopers Grocery Cards have you ordered?
Your answer
How many $2.50 Reloadable Safeway Grocery Cards have you ordered?
Your answer
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