SUPPORTER ORDER FORM NAME OF SUPPORTER: ______PHONE NUMBER: ______DATE: ______ADDRESS: ______POSTAL CODE: ______EMAIL: ______NAME OF PARENT: ______GRADE/CLASS: ______MERCHANT(FEE) CERTIFICATES TOTAL MERCHANT(FEE) CERTIFICATES TOTAL Department Stores: Specialty Stores: (DB) Giant Tiger 3.0% x $25.00 (DB) Amazon.ca 2.0% x $25.00 x $100.00 $ ______x $50.00 (DB) Hudsons Bay (Hbc, 3.0% x $25.00 x $100.00 $ ______Home Outfitters) x $50.00 (DB) American Eagle 5.0% x $25.00 $ ______x $100.00 $ ______(DB) Bath and Body Works 5.0% x $25.00 $ ______(DB) London Drugs 2.0% x $25.00 (DB) Best Buy 2.0% x $25.00 x $50.00 x $50.00 x $100.00 $ ______x $100.00 $ ______(DB)Walmart 2.0% x $25.00 (DB) Canadian Tire 3.0% x $25.00 x $50.00 x $50.00 x $100.00 x $100.00 $ ______x $250.00 $ ______(DB) Chapters/Indigo/Coles 5.0% x $25.00 x $50.00 $ ______Fuel: (DB) Claire's Store 7.5% x $25.00 $ ______(DB) Esso 2.0% x $25.00 (DB) i-Tunes 3.0% x $10.00 x $50.00 x $25.00 $ ______x $100.00 $ ______(DB) La Senza 5.0% x $25.00 $ ______(DB) Petro-Canada 2.0% x $25.00 (DB) M&M Meat Shops 3.0% x $25.00 $ ______x $50.00 (DB) Mark's Work 5.0% x $25.00 x $100.00 $ ______Wearhouse x $50.00 (DB) Shell 2.0% x $25.00 x $100.00 $ ______x $50.00 (DB) Options (Gap, Old Navy, 5.0% x $25.00 x $100.00 $ ______Banana Republic) x $50.00 $ ______(DB) Pet Smart 3.0% x $25.00 $ ______Home Improvement: (DB) Shoppers Drug Mart 3.0% x $25.00 (DB) Home Depot 2.0% x $25.00 x $50.00 x $50.00 x $100.00 $ ______x $100.00 (DB) Sport Chek 3.0% x $25.00 x $250.00 $ ______x $50.00 (DB) Home Hardware 3.0% x $25.00 x $100.00 $ ______x $50.00 (DB) Staples 3.0% x $25.00 x $100.00 $ ______x $50.00 (DB) Lowe's 2.0% x $25.00 x $100.00 x $50.00 x $250.00 $ ______x $100.00 $ ______(DB) Starbucks 5.0% x $10.00 (DB) Rona 5.0% x $25.00 x $25.00 x $50.00 x $50.00 x $100.00 $ ______x $100.00 $ ______Specialty Stores: Entertainment: (DB) The Children's Place 5.0% x $25.00 $ ______(DB) Cineplex Odeon 5.0% x $10.00 (DB) Winners / Marshalls / 5.0% x $25.00 (Famous Players,Galaxy, x $25.00 Home Sense x $50.00 $ ______SilverCity, Colossus x $50.00 $ ______,Paramount) Restaurants: Travel: (DB) Boston Pizza 5.0% x $25.00 (NC) Avis Car Rental 5.0% x $50.00 $ ______x $50.00 $ ______(DB) Brown's Socialhouse 5.0% x $25.00 (DB) Fairmont Hotels 5.0% x $100.00 $ ______x $50.00 $ ______(DB) Cactus Club 10.0% x $25.00 Spas x $50.00 $ ______(DB) WaySpa 7.5% x $50.00 (DB) Cara-The Ultimate Dining Card 3.0% x $25.00 x $100.00 $ ______(Milestones, Kelseys, Swiss x $50.00 $ ______Grocery Stores: Chalet, Montana's, New York Fries, (DB) 3.0% x $25.00 Harvey's, East Side Marios and more) (Superstore, Wholesale Club, x $50.00 (DB) Darden Restaurants No Frills, Shop Easy, ) x $100.00 Olive Garden 5.0% x $25.00 $ ______x $250.00 $ ______Red Lobster 5.0% x $25.00 $ ______(DB) Save-On-Foods, Urban Fa 4.0% x $25.00 (DB) Earls 5.0% x $25.00 PriceSmart Foods, x $50.00 x $50.00 $ ______Overwaitea Foods x $100.00 (DB) Joey Restaurant 5.0% x $25.00 x $250.00 $ ______x $50.00 $ ______(DB) and 4.0% x $25.00 (DB) Keg 5.0% x $25.00 (IGA, Bonichoix, , x $50.00 x $50.00 Foodtown,Omni Foods, Price x $100.00 x $100.00 $ ______Chopper,Needs,Commisso's x $250.00 $ ______(DB) McDonald's 3.0% x $10.00 ,Tradition, Sobeys) x $25.00 (DB) T&T 2.0% x $25.00 x $50.00 $ ______(Osaka) x $50.00 $ ______(DB) Moxie's 10.0% x $25.00 $ ______(DB) Old Spaghetti Factory 5.0% x $25.00 $ ______(DB) Pizza Pizza 15.0% x $25.00 $ ______(DB) Red Robin 5.0% x $25.00 $ ______(DB) Subway 5.0% x $10.00 GRAND TOTAL: $ x $25.00 x $50.00 $ ______(DB) Tim Hortons 3.0% x $10.00 x $25.00 x $50.00 $ ______(DB) White Spot 5.0% x $25.00 $ ______x $50.00 $ ______(DB) Triple O's 5.0% x $25.00 $ ______Revised Oct 2018