CPU SCRIP ORDER FORM Your Name Pre/PrimaryIntermediate MS HS

Home Phone Work/Cell

Pick Up Order at Office OR Send Home Within Friday Folder / Student's Name Teacher Name SCRIP - it's fundraising while you shop!!

Check out the COMPLETE retailer list at www.glscrip.com/retailerlist - If you find a retailer you would like to purchase that is not on the order form, just write in your order on the bottom of the form and add it to your total! Questions: Contact Ann Wooldridge; 849-1102 Orders due the 2nd and 4th Monday of Each Month-1/9, 1/23, 2/6, 2/20, 3/5, 3/19, 4/9, 4/23, 5/7, 5/21 GROCERIES AND GAS/CAR Business % Profit Qty Value Total Business % Profit Qty Value Total Walmart/Sam's Club 2% $25 $ BP Gas Corner Store 1.5% $50 $ Walmart/Sam's Club 2% $100 $ BP Gas Corner Store 1.5% $100 $ Walmart/Sam's Club 2% $250 $ Sinclair Travel Plaza 1.50%1.5% $25 $ Jiffy Lube 11% $30 $ Sinclair Travel Plaza 1.50%1.5% $100 $ DEPARTMENT & DISCOUNT STORES JCPenney 5% $25 $ Sears 4% $25 $ JCPenney 5% $100 $ Sears 4% $100 $ Younkers 8% $25 $ Target 2% $25 $ Younkers 8% $100 $ Target 2% $100 $ Kohl's 4% $25 $ Land's End 16% $25 $ Kohl's 4% $100 $ Pier 1 9% $25 $ Old Navy 14% $25 $ Dick's 8% $25 $ Payless Shoes 13% $20 $ Dick's 8% $100 $ Children's Place 12% $25 $ Kmart 4% $25 $ American Eagle 10% $25 $ Kmart 4% $50 $ Buckle 8% $25 $ Gander Mountain 8% $25 $ Aeropostel 7% $25 $ Cabela's 11% $25 $ Claire's 9% $10 $ Gordman's 7% $25 $ Applebee's 8% $25 $ Noodles and Company 8% $10 $ Arby's 8% $10 $ KFC 9% $5 $ Wendy's 4% $10 9% $10 $ Buffalo Wild Wings 8% $25 $ Panera Bread 9% $25 $ 4% $10 $ Papa John's 10% $10 $ Carlos O'Kelly 9% $10 $ Papa Murphy's 10% $5 $ Chili's 11% $25 $ Papa Murphy's 10% $10 $ Chuck E. Cheese 8% $10 $ Pizza Hut 8% $10 $ Hardees 5% $10 $ Red / 9% $25 $ 8% $10 $ 9% $25 $ 5% $10 $ Ruby Tuesday's 8% $25 $ 3% $10 $ Starbuck's 7% $10 $ Subway 3% $50 $ Starbuck's 7% $25 $ 10% $10 $ Texas Roadhouse 8% $25 $ ENTERTAINMENT - BOOKS, MUSIC Barnes&Noble/B.Daltonble 9% $10 $ Shutterfly 9% $25 $ Barnes&Noble/B.Daltonble 9% $25 $ iTunes 5% $15 $ Barnes&Noble-Teacher Gift 9% $20 $ iTunes 5% $25 $ Best Buy 3% $25 $ Amazon 4% $25 $ Best Buy 3% $100 $ Amazon 4% $100 $ HOME IMPROVEMENT & OFFICE Home Depot 4% $25 $ Lowe's 4% $25 $ Home Depot 4% $100 $ Lowe's 4% $100 $ Office Max 5% $25 $ Lowe's 4% $1,000 $ Office Max 5% $100 $ Menard's 3% $25 $ Office Depot 4% $25 $ Menard's 3% $100 $ HEALTH & BEAUTY Bath & Body Works 18% $10 $ Bed Bath and Beyond 7% $25 $ Bath & Body Works 18% $25 $ Ulta 4% $25 $ GLSCRIP.COM RETAILER WRITE INS $ $ $ $ ***Please make checks payable to CPU Schools*** SHEET TOTAL $