Current In-Stock Retailers

St. Patrick School – SCRIP Program Order Form To facilitate the process of orders, please indicate the Total Dollar Amount desired for each certificate instead of the number of certificates. Orders will be accepted Tuesday, Wednesday, and Thursday through your child’s Home Folder, and on Saturdays after mass and Sunday’s in the Narthex between 9:00 am-12:30pm. Thank you for your participation. CURRENT IN-STOCK RETAILERS: CURRENT IN-STOCK RETAILERS: Category: Grocery/Drug Stores: Category: Retailers: CVS Pharmacy (6.0%) $25______Barnes & Noble (8.0%) $10 ______Jewel/Osco (4.0%) $25 ______Bass Pros Shops (9.0%) $25______$100______Bath & Body Works (13.0%) $10______Meijer (3%) $50______Bed Bath & Beyond (7.0%) $25______$100______Best Buy (4.0%) $25______Mariano’s ( Roundy’s) (4.0%) $25______Dennis Uniform (5.0%) $20______$100______Gap/Old Navy (14.0%) $25______Walgreen’s (6.0%) $25______Home Depot/Home Expo (4.0%)* $25______$100______$100______WalMart/Sam’s (2.5%) $25______ITunes (5.0%) $15______$100______Kohl’s (4.0%)** $25______Woodman’s (5.0%) $50______$100______$100______Lands’ End (16.0%) $25______Lowe’s (4.0%) $25______Category: Restaurants: Macy’s (10.0%) $25 ______Buffalo Wild Wings (8.0%) $10______Marcus Corp. (9.0%) $25______Cheesecake Factory (5.0%) $25______Marshalls/TJ Maxx (7.0%) $25______Chili’s (11.0%) $25______Menard’s (3.0%) $25______Chipotle Mexican Grill (10.0%) $10______$100______Cracker Barrel (8.0%) $10______Old Navy/Gap (14.0%) $25______Domino’s Pizza (8.0%) $10______Pet Smart (5.0%) $25______Dunkin Donuts (3.0%) $10______Target (2.5%) $25______Olive Garden/Red Lobster (8.0%) $25______$100______Outback Steakhouse (8.0%) $25______Toys-R-Us/Kids-R-Us (3.0%) $20______Panera Bread (8.0%) $10______Ulta 3 Cosmetics (4.0%) $25______Red Robin (8.0%) $25 ______Starbucks (7.0%) $10______Category: Scrip Bucks (4.0%): Subway (6.0%) $10______Amount $5____ $10____ $15____ $20____ $25____ Texas Roadhouse (8.0%) $25______$50.00____ Total $______TGIFriday’s (9.0%) $25______-Redeemable at the St. Patrick Scrip table for Scrip certificates only; cannot be exchanged for cash. Category: Automotive: -Retailers, denominations, and discount amounts subject to BP Gas Card (1.5%) $50______change without notice. No returns or exchanges. SPECIAL Kwik Trip (4.0%) $25______REQUESTS MUST BE PAID FOR AT TIME OF ORDER. Marathon (3.0%) $25______--Place your order by 12 PM on Sunday to get your order the Mobil/Exxon (1.0%) $50______following Wednesday. Shell Gas Card (2.0%) $50______*Home Depot $500 available upon request. Speedway (4.0%) $25______.**This retailer will accept gift certificates as payment $100______on charge accounts.

Scrip is now available online. Many more retailers are available with online orders. Go to Shopwithscrip.com to see full list of retailers. Contact the school office for online ordering information.

*Send w/ Child: (Please read and sign): I hereby authorize St. Patrick School to release this certificate order through the school to my child. I will not hold the school responsible for any lost certificates. I would like my student, ______in room ______, to bring home the store certificates.

Signature:______Date: ______

Certificate Distribution Method (Check One): Pick up In Person:_____ *Send w/Child:______A check payable to St. Patrick School must be attached to this form. (Your account is your first and last name.)

Name:______Account :______Phone:______Total $:______9/25/2017