Kennedy Elementary Scrip Order Form

Product % QTY Total Product % QTY Total Product % QTY Total Product % QTY Total GROCERIES Best Buy $25 3% $ Sears $100 4% $ $10 9% $ Meijer $25 3% $ Best Buy $100 3% $ Shopko $25 3% $ Panera Bread $25 9% $ Meijer $50 3% $ Best Buy $250 3% $ Shopko $50 3% $ Papa John's $10 8% $ Metro Market $25 4% $ Boston Store $25 8% $ Shutterfly $25 9% $ Papa Murphy's $10 8% $ Metro Market $50 4% $ Boston Store $100 8% $ T.J. Maxx $25 7% $ $10 8% $ Peapod Online Groc. $25 4% $ Cabela's $25 11% $ T.J. Maxx $100 7% $ Mexican Grill $25 7% $ Pick 'n Save $25 4% $ Cabela's $100 11% $ Target $25 2% $ ® $25 9% $ Pick 'n Save $50 4% $ Children's Place $25 12% $ Target $100 2% $ $10 7% $ Pick 'n Save $100 4% $ Claire's $10 9% $ Toys"R"Us $20 3% $ Starbucks $25 7% $ Piggly Wiggly $25 3% $ Dick's $25 8% $ Walgreens $25 6% $ ® $10 3% $ Piggly Wiggly $50 3% $ Dick's $100 8% $ Walgreens $100 6% $ SUBWAY® $50 3% $ Piggly Wiggly $100 3% $ GNC $25 8% $ Walmart $25 2.5% $ $10 5% $ GAS/VEHICLE NEEDS GameStop $25 3% $ Walmart $100 2.5% $ Wendy's $10 4% $ BP $50 1.5% $ Gap $25 14% $ Younkers $25 8% $ ENTERTAINMENT BP $100 1.5% $ Gap $100 14% $ Younkers $100 8% $ Disney $25.00 2% $

Citgo $50 (not online) 10% $ Gymboree $25 13% $ Zappos.com $25 8% $ Disney $100.00 2% $ Citgo $100 not online 10% $ Hallmark $25 4% $ Zappos.com $100 8% $ Family Video $10 12% $ Kwik Trip $25 9% $ Home Depot $25 4% $ RESTAURANTS Gift Card Holder 10 Slot $3 25% $

Kwik Trip $50 9% $ Home Depot $100 4% $ Applebee's $25 10% $ Gift Card Wrapper 10 Pk $2 10% $ Mobil $50 1% $ jcpenney $25 5% $ Applebee's $50 10% $ Groupon.com $25 7% $ Shell $25 3% $ Kohl's $25 4% $ Arby's $10 8% $ iTunes® $15 5% $ Shell $50 3% $ Kohl's $100 4% $ bd's Mongolian Grill $20 8% $ iTunes® $25 5% $ Speedway $25 4% $ Lands' End $25 16% $ Buffalo Wild Wings $10 8% $ Marcus Theatres $25 9% $ Speedway $100 4% $ Lands' End $100 16% $ Buffalo Wild Wings $25 8% $ Marcus Theatres $100 9% $ RETAIL Maurices $20 7% $ $10 4% $ NOOK by B & N $10 9% $ Ace Hardware $25 4% $ Menards $25 3% $ California Pizza Kit. $10 4% $ Ace Hardware $100 4% $ Menards $100 3% $ Cheesecake Fact. $25 5% $ Family Order Form Aeropostale $25 7% $ Michaels $25 4% $ Chili's Grill $25 11% $ Kennedy Family School Organization Amazon.com $100 3% $ Office Max $25 5% $ Chili's Grill $50 11% $ For questions call Lisa Rau 262-204-8005 Amazon.com $25 3% $ Office Max $100 5% $ Cousins Subs $10 9% $ or email [email protected] American Eagle Outfit. $25 10% $ Old Navy $25 14% $ $10 3% $ American Girl $100 9% $ Old Navy $100 14% $ Domino's Pizza $10 8% $ Name Phone #: American Girl $25 9% $ Oriental Trading Co. $25 9% $ Fazoli's $25 7% $ Check # Total Amt. Barnes & Noble $10 9% $ Payless Shoes $20 13% $ KFC $5 8% $ Order Date Barnes & Noble $100 9% $ PetSmart $25 4% $ Little Caesar's $20 8% $ Created 3/14 Barnes & Noble $25 9% $ Pier 1 Imports $25 9% $ McDonald's $5 not online 5% $ Check out ShopWithScrip.com for more Bath & Body Works $10 13% $ RadioShack $25 4% $ Noodles & Co. $10 8% $ vendors, to order online, or sign up to Bath & Body Works $25 13% $ Sally Beauty Supply $25 12% $ Olive Garden ® $25 9% $ withdraw from your checking account Bed Bath & Beyond $25 7% $ Sears $25 4% $ P.F. Chang's China B $25 8% $ our code is DA9CFBE437285

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