Thank you for your interest in St. Augustine's HEP Scrip Program. To become a member please complete the form below. You may also download the registration form and drop it off at the desigated office of St. Augustine's HEP.

THE PARTICIPANT HAS READ, DOES UNDERSTAND AND WILL ABIDE BY THE GENERAL POLICIES OF THE ST. AUGUSTINE'S HEP TUITION ASSISTANCE INCENTIVE PROGRAM. THE PARTICIPANT FURTHER UNDERSTANDS THAT E-MAIL IS THE OFFICIAL COMMUNITCATION METHOD OF THE ST. AUGUSTINE HEP AND THAT NOTICES, PROCEDURES, POLICIES AND DATES WILL BE DISTRIBUTED FROM THE E-MAIL ADDRESS monzaskier@bex.net. THE PARTICIPANT ALSO UNDERSTAND THAT BY REGISTERING THROUGH THE USE OF THIS FORM CONSTITUTES A DIGITAL SIGNATURE ON HIS/HER PART.