Christ Our Savior Scrip Order Form

Pickup next Sunday if not available at COS scrip store. Name:______Cash or checks only or order by Sunday 6pm at www.shopwithscrip.com using your prestopay account Phone:______

Date:______Questions: Cheri Schaefer, [email protected], 695-1822 # of cards to order:______Sandi Blackwell, sbselzhomz@.com, 246-8486 check #/amount:______Terri Schiedemeyer, [email protected], 246-8171 cards carried:______Sue Fassbender, [email protected], 262-894-2579 Apparel & Accessories Grocery % Qty Total % Qty Total Aeropostale $25 7% $ Pick-n-Save $25 4% $ American Eagle Outfitters $25 10% $ Pick-n-Save $100 4% $ Buckle $25 8% $ Piggly Wiggly $25 4% $ Burlington Coat Factory $25 8% $ Piggly Wiggly $50 4% $ Claire's $10 (No fee card) 9% $ Piggly Wiggly $100 3% $ Dress Barn $25 8% $ Sentry $50 3% $ Eddie Bauer $25 9% $ Whole Foods $25 3% $ Express $25 10% $ Whole Foods $100 3% $ Fashion Bug $25 6% $ Casual and Fine Dining Finish Line $25 10% $ % Qty Total Ft. Locker $25 9% $ Applebee's $25 8% $ Gap/Banana/Old Navy $25 14% $ Bonefish $25 8% $ $25 13% $ Boston Market $10 12% $ J. Crew $25 13% $ Bravo Cucina $25 12% $ Lands' End $25 16% $ Buca di Beppo $25 8% $ Limited $25 9% $ Buffalo Wild Wings $25 8% $ Maurices $20 7% $ California Pizza Kitchen $10 4% $ Men's Wearhouse $25 8% $ Carrabbas Italian Grill $25 8% $ Nine West $25 8% $ Champps Restaurant $25 5% $ Payless Shoes $20 13% $ Cheesecake Factory $25 5% $ Talbots $25 11% $ Chili's $25 9% $ The Children's Place $25 12% $ Chuck E Cheese $10 8% $ TJ Maxx/Marshall's $25 7% $ Claim Jumper $25 8% $ TJ Maxx/Marshall's $100 7% $ Cracker Barrel $25 9% $ Wet Seal $25 7% $ Denny's $10 7% $ Department Store Flemings $25 5% $ % Qty Total IHOP $25 8% $ Boston Store $25 10% $ Magiannos $25 11% $ Boston Store $100 10% $ Mason Street Grill $25 9% $ JCPenney $25 5% $ Mason Street Grill $100 9% $ JCPenney $100 5% $ Milwaukee Chophouse $25 9% $ Kohl's Dept. Store $25 4% $ Milwaukee Chophouse $100 8% $ Kohl's Dept. Store $100 4% $ Noodle's & Co. $10 8% $ Macy's/Federated $25 10% $ Old Country Buffet $25 5% $ Macy's/Federated $100 10% $ Olive Garden $25 9% $ $25 4% $ Outback $25 8% $ Sears $100 4% $ P.F. Chang's $25 8% $ Discount Store Red Lobster $25 9% $ % Qty Total Red Robin 9% $ Kmart $25 4% $ Rock Bottom $25 6% $ Kmart $50 4% $ Steak and Shake $10 8% $ Shopko $25 3% $ Texas Roadhouse $25 8% $ Shopko $50 3% $ TGI Fridays $25 9% $ Target $25 2% $ Target $100 2% $ Wal-mart/Sam's Club $25 2% $ Wal-mart/Sam's Club $100 2% $

1 Christ Our Savior Scrip Order Form

Dining - On The Go Electronics % Qty Total % Qty Total Arby's $10 4% $ Best Buy $25 3% $ $10 10% $ BEST BUY $100 3% $ Chipotle Mexican Grill $10 8% $ Game Stop $25 3% $ Cold Stone Creamery $10 9% $ Office Depot $25 4% $ Cousins Subs $10 5% $ Office Max $25 5% $ Culvers $10 10% $ RadioShack $25 4% $ Domino's $5 4% $ Staples $25 Gift Card 5% $ Dunkin Donuts $10 7% $ Entertainment Dunn Bros Coffee $10 8% $ % Qty Total Einstein Bros Bagels $10 10% $ AMC/Loews Cinemas $25 7% $ Fazoli's $25 9% $ Barnes & Noble/B.Dalton $10 9% $ Hardees $10 8% $ Barnes & Noble Teacher Gift $20 9% $ KFC $5 10% $ Barnes & Noble/B.Dalton $25 9% $ Mrs. Field's Cookies $5 9% $ Blockbuster $10 7% $ Panera Bread $10 8% $ Online & Mail Order Panera Bread $25 8% $ % Qty Total Pizza Hut $10 7% $ Amazon.com $25 4% $ Qdoba $25 7% $ iTunes $15 5% $ Starbucks $10 7% $ iTunes $25 5% $ Subway $10 3% $ LL Bean $100 Card 15% $ Taco Bell $10 5% $ Shutterfly $25 card 14% $ Home Decor Specialty Retailer % Qty Total % Qty Total Crate & Barrel $25 8% $ Bath & Body Works $10 13% $ Crate & Barrel $100 8% $ Bath & Body Works $25 13% $ Pier 1 $25 9% $ Bed Bath and Beyond $25 7% $ Pottery Barn/Wlm Sonoma $25 8% $ Build-A Bear Wkshp $25 8% $ Pottery Barn/Wlm Sonoma $100 8% $ CVS Pharmacy $25 6% $ Restoration Hardware $25 12% $ Honey Baked Ham $25 12% $ Pottery Barn/Wlm Sonoma $100 8% $ Jo Ann Fabrics $20 6% $ Restoration Hardware $25 12% $ Kay Jewelry $50 6% $ Home Improvement KB Toys $20 9% $ % Qty Total $25 4% $ Ace Hardware $25 4% $ Sephora $20 4% $ Ace Hardware $100 4% $ Toys R Us $20 2% $ Home Depot $25 4% $ Walgreens $25 6% $ Home Depot $100 4% $ Walgreens $100 6% $ Lowe's $25 4% $ Ulta Salons $25 4% $ Lowe's $100 4% ` $ Sporting Goods Menard's $25 3% $ % Qty Total Menard's $100 3% $ Cabela's $25 Card 11% $ Marcus Theatre/Resort $25 9% $ Cabela's $100 Card 11% $ Gas & Auto Dunham's Sports $25 8% $ % Qty Total Finish Line $25 10% $ Advanced Auto Parts $25 7% $ Gander Mountain $25 8% $ BP Gas Stations $50 1.5% $ Nike Store $25 12% $ Kwik Trip $25 4% $ Sports Authority $25 8% $ Kwik Trip $100 4% $ Marathon $25 3% $ Mobile/Exxon $50 2% $ Shell Stations $25 3% $ Shell Stations $50 3% $ Speedway/SuperAmerica $25 4% $ Speedway/SuperAmerica $100 4% $ Texaco $25 2% $

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