CHRISTMAS 2017 SUPPORTER ORDER FORM

STUDENT’S NAME: PHONE NUMBER: ______EMAIL: ______PARENT’S NAME: ______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 $ ______(DB) Claire's Store 7.5% x $25.00 $ ______(DB) iTunes 3.0% x $10.00 Fuel: x $25.00 $ ______(DB) Esso 2.0% x $25.00 (DB) La Senza 5.0% x $25.00 $ ______x $50.00 (DB) M&M Food Market 3.0% x $25.00 $ ______x $100.00 $ ______(DB) Mark's Work 5.0% x $25.00 (DB) Petro-Canada 2.0% x $25.00 Wearhouse x $50.00 x $50.00 x $100.00 $ ______x $100.00 $ ______(DB) Options (Gap, Old Navy, 5.0% x $25.00 (DB) Shell 3.0% x $25.00 Banana Republic) x $50.00 $ ______x $50.00 (DB) PetSmart 3.0% x $25.00 $ ______x $100.00 $ ______(DB) Shoppers Drug Mart 3.0% x $25.00 Home Improvement: x $50.00 (DB) Home Depot 2.0% x $25.00 x $100.00 $ ______x $50.00 (DB) Sport Chek 3.0% x $25.00 x $100.00 x $50.00 x $250.00 $ ______x $100.00 $ ______(DB) Home Hardware 3.0% x $25.00 (DB) Staples 3.0% x $25.00 x $50.00 x $50.00 x $100.00 $ ______x $100.00 (DB) Lowe's 2.0% x $25.00 x $250.00 $ ______x $50.00 (DB) Starbucks 5.0% x $10.00 x $100.00 $ ______x $25.00 (DB) Rona 5.0% 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,SilverCity, x $25.00 $ ______Home Sense x $50.00 $ ______Colossus,Paramount) 1 Travel: (NC) Avis Car Rental 5.0% x $50.00 $ ______

Restaurants: (DB) Fairmont Hotels 5.0% x $100.00 $ ______(DB) Boston Pizza 5.0% x $25.00 x $50.00 $ ______Spas (DB)Browns Socialhouse 8.0% x $25.00 (DB) WaySpa 7.5% x $50.00 x $50.00 $ ______x $100.00 $ ______(DB) Cactus Club 10.0% x $25.00 x $50.00 $ ______(DB) Cara-The Ultimate Dining Card 3.0% x $25.00 Grocery Stores: (Milestone's, Kelsey's, Swiss x $50.00 $ ______(DB) 3.0% x $25.00 Chalet, Montana's, New York Fries (Superstore, Wholesale Club, x $50.00 Harvey's, East Side Marios and more) No Frills, Shop Easy, ) x $100.00 (DB) Darden Restaurants x $250.00 $ ______Olive Garden 5.0% x $25.00 $ ______(DB) Save-On-Foods, Urban Fa 4.0% x $25.00 Red Lobster 5.0% x $25.00 $ ______PriceSmart Foods, x $50.00 (DB) Earls 5.0% x $25.00 x $100.00 x $50.00 $ ______x $250.00 $ ______(DB) Joey Restaurant 5.0% x $25.00 (DB) and 5.0% x $25.00 x $50.00 $ ______(IGA, Bonichoix, , x $50.00 (DB) Keg 5.0% x $25.00 Foodtown,Omni Foods, Price x $100.00 x $50.00 Chopper,Needs,Commisso's, x $250.00 $ ______x $100.00 $ ______Tradition, Sobeys) (DB) Moxie's 10.0% x $25.00 $ ______(DB) T&T 2.0% x $25.00 (DB) Old Spaghetti Factory 5.0% x $25.00 $ ______(Osaka) x $50.00 $ ______(Bonus $10 card with every $25) GRAND TOTAL: $ (DB) Pizza Pizza 15.0% x $25.00 $ ______(DB) Red Robin 5.0% x $25.00 $ ______(DB) Subway 5.0% x $10.00 CANNOT PAY OFF ACCOUNT WITH CARDS OR CERTIFICATES x $25.00 x $50.00 $ ______DB: Declining Balance Shopping Card (DB) Tim Hortons 3.0% x $10.00 C: Change Back Shopping Certificate x $25.00 NC: No Change Back Shopping Certificate x $50.00 $ ______(DB) White Spot 5.0% x $25.00 $ ______Revised Oct 2017 x $50.00 $ ______(DB) Triple O's 5.0% x $25.00 $ ______

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