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Scrip Order Form OLR-2.Xls OLR SCRIP GIFT CARD ORDER FORM TODAY'S DATE: YOUR NAME: Your cell number: Contact: Your email: Instructions: Circle your choice, write your quantity and total in the blanks below. Certificate Denominations Qt. Total Certificate Denominations Qt. Total Example: Ingles $5 $10 $25 2 $50 Example: Publix $25 $100 1 $100 Grocery/Drug/VISA cards INGLES (5%) $50 $100 CVS (4%) $25 $100 PUBLIX (3%) $25 $50 $100 Rite Aid (4%) $25 $100 SAM'S/WAL-MART (1.5%) $25 $50 $100 Walgreens (6%) $25 $100 WHOLE FOODS (3%) $25 $100 Visa ** (1.5%) $50 $100 $250 Food Lion (3%) $25 $100 National and Online Retailers Academy Sports (4%) $25 $100 Kohl's* (4%) $25 $100 Aerie (6%) $25 Lady Footlocker (8%) $25 Amazon.com (3%) $10 $25 $50 Lowe's (4%) $25 $50 $100 Amazon.com (3%) (cont) $100 $250 Lowe's Continued (4%) $500 American Eagle (6%) $25 MasterCuts (9%) $25 American Girl (9%) $25 Macy's (10%) $25 $100 Baby Depot (8%) $25 Marshalls/TJ Max/HomeGoods(7%) $25 BananaRepublic/OldNavy/GAP (14%) $25 Michaels (4%) $25 Barnes & Noble/Colege Bookstores(8%) $25 Nike Gift Card (12%) $25 Bath & Body Works (18%) $10 $25 Nike Women Stores (12%) $25 Beauty Bar (9%) $25 Nordstrom (4%) $25 Bed Bath & Beyond (6%) $25 $100 Office Depot/Office Max (4%) $25 Best Buy (2%) $25 $50 Old Navy/Banana Rep. (14%) $25 Bob's Stores (9%) $25 PB Teen (8%) $25 Build-A-Bear (8%) $25 Panopoulos Hair Salons (9%) $25 Burlington Coat Factory (8%)$25 Petco (5%) $25 buybuy BABY-New! (6%) $25 $100 PetSmart (5%) $25 Cabela's (9%) $25 $50 Pinkberry (8%) $10 $25 Carlton Hair International (9%)$25 Pottery Barn (8%) $25 $100 Christmas Tree Shops (6%) $25 $100 Pottery Barn/Kids/Teen (8%) $25 Columbia (12%) $50 Regal Theater (8%) $10 $25 Dick's Sporting Goods (5%) $25 REI Stores (8%) $25 Dennis Uniform (5%) $20 ROSS Dress For Less (9%) $25 Disney Stores (3%) $25 Sally Beauty (12%) $25 Foot Locker (8%) $25 Sephora (5%) $25 GameStop (3%) $25 See's Candies 1LB $20.50 (20%) Gap Kids (14%) $25 Shutterfly (9%) $25 Goody's (8%) $25 Staples (5%) $25 $100 Hallmark (4%) $25 Stage Stores (8%) $25 Home Depot (4%) $25 $50 $100 Sunglass Hut (9%) $25 Home Goods (7%) $25 Talbots (9%) $25 iTunes (5%) $25 Target (2.5%) $25 $50 $100 Jean Louis David (9%) $25 TJ Maxx (7%) $25 $100 Kid's Foot Locker (8%) $25 Wal-Mart/Sam's (1.5%) $25 $50 $100 JoAnn Fabrics (6%) $25 Williams-Sonoma (8%) $25 Yankee Candle (8%) $25 Zappos (7%) $25 TURN THIS SHEET OVER for RESTAURANTS and more !!! Certificate Denominations Qt. Total Certificate Denominations Qt. Total Example: Ingles $5 $10 $25 2 $50 Example: Publix $25 $100 1 $100 National Restaurants Applebee's (8%) $25 Jamba Juice (7%) $15 Arby's (8%) $10 Krispy Kreme (8%) $10 $50 Bonefish Grill (8%) $25 $50 Little Caesars (8%) $20 Burger King (4%) $10 LongHorn Steak House (8%) $10 $25 $50 California Pizza Kitchen (8%)$25 O'Charley's (13%) $10 $25 Carrabba's Italian Grill (8%) $25 $50 Olive Garden (8%) $10 $25 $50 Cheddar's Scratch Kitchen (8%) $10 $25 $50 On the Border (10%) $25 Cheesecake Factory (5%) $25 Panera Bread (8%) $10 $25 Chipotle (11%) $10 $25 Papa John's (8%) $10 $100 Chili's (10%) $25 Red Lobster (8%) $25 Chuck E. Cheese (8%) $10 Red Robin (9%) $25 Cracker Barrel (8%) $10 $25 Ruby Tuesday (6%) $25 Denny's (7%) $10 Ruth Chris Steakhouse (8%) $50 Domino's (8%) $10 $50 Seasons 52 (8%) $10 $25 $50 Dunkin Donuts (3%) $10 $50 Starbucks (7%) $5 $10 $25 El Pollo Loco (6%) $25 Steak 'n Shake (8%) $10 Fatz Cafe (12%) $25 Subway (3%) $10 $25 Fleming's (8%) $25 $50 Taco Bell (4%) $10 Golden Corral (8%) $25 Texas Roadhouse (8%) $10 $25 Hardee's (5%) $10 TGI Friday's (9%) $25 Honey Baked Ham (13%) $25 Wendy's (4%) $10 IHOP (8%) $25 Yard House (8%) $10 $25 $50 Vehicle Care/Gas Cards Hotels/Travel Advance Auto Parts (7%) $25 $500 Budget Rental Car (8%) $50 AutoZone (8%) $25 Carnival Cruise Lines (8%) $100 BP Gas Stations (1.5%) $50 $100 Exxon (1%) $50 $100 Delta Airlines (4%) $250 $500 Marathon (3%) $25 Disneyworld/Disneyland (3%)$25, $100, $500, & $1000 Movie tickets now on front page… SCRIP Pickup Paid with cash Total I would like to make arrangments to pick up my SCRIP Paid with check $_____________ I will pick up SCRIP at the school office. Please send cards home in my child's folder. Please make checks payable to OLR SCRIP MORE CARDS AVAILABLE!! GO TO SCRIPZONE.COM TO SEE THEM ALL! **Visa Gift Cards will charge you a monthly fee if they are not 100% used by six months from issue date. Questions? Email [email protected] THANK YOU SO MUCH FOR YOUR ORDER! PLEASE ORDER AGAIN SOON!.
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