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P.C.S. 2014-15 $CRIP-GIFT CARD Order Form

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P.C.S. 2014-15 $CRIP-GIFT CARD Order Form 8/27/2014 P.C.S. 2014-15 $CRIP-GIFT CARD Order Form YOUR NAME Daytime Phone **Benefit to PCS is indicated by the percentage next to each merchant Student's Name/Classroom DEPARTMENT STORES Denom Qty Total RESTAURANTS (cont) Denom Qty Total Bloomingdale's (12%) 25 or 100 El Pollo Loco (6%) 10 JC Penney (5%) 25 or 100 Honeybaked Ham (12%) 25 Kohl's (4%) 25 or 100 IHOP (8%) 25 Macys (10%) 25 or 100 Islands (8%) 25 Sears (4%) 25 or 100 Jack-in-the-Box (4%) 10 Target (2.5%) 25 or 100 Jamba Juice (7%) 10 Walmart (2.5%) 25 or 100 KFC (8%) 5 DRUG STORES Mimi's Café (8%) 25 CVS Pharmacy (6%) 25 Olive Garden/Red Lobster (9%) 25 Rite Aid (4%) 25 Outback Steakhouse (8%) 25 Walgreens (6%) 25 PF Changs/Pei Wei (8%) 25 ENTERTAINMENT Panda Express (8%) 25 AMC/Loews/Cineplex (8%) 25 Panera Bread (9%) 10 or 25 AMC single ticket (10%) 9.50 Peet's Coffee and Tea (8%) 20 Disney (2%) 25 or 100 Pinkberry (5%) 10 Regal/Edwards/UA Theatres (8%) 25 Pizza Hut (8%) 10 Regal/Edwards/UA single ticket (10%) 9.50 Red Robin (9%) 25 Six Flags Magic Mtn. - 1-day admission 43 Ruth's Chris Steak House (10%) 50 GROCERIES Souplantation (8%) 25 Smart & Final (3%) 25 or 100 Starbucks's (7%) 10 or 25 Sprouts Farmers Markets (5%) 25, 50 or 100 Subway (3%) 10 Vons/Pavillions (4%) 25 or 100 Taco Bell (5%) 10 Whole Foods (3%) 25 or 100 Wendy's (4%) 10 HARDWARE & HOME SPECIALTY STORES Home Depot (4%) 25 or 100 Aeropostale (7%) 25 Lowe's (4%) 25 or 100 Amazon.com (3%) 25 or 100 RESTAURANTS American Eagle Outfitters (10%) 25 Acapulco/El Torito (8%) 25 American Girl (9%) 25 or 100 Applebees (8%) 25 Barnes & Noble/B.Dalton (9%) 10 or 25 Baja Fresh (7%) 25 Bass Pro Shops (9%) 25 or 100 Black Angus (12%) 25 Bath & Body Works (13%) 10 or 25 Buca de Beppo (8%) 25 Bed, Bath & Beyond (7%) 25 or 100 Buffalo Wild Wings (8%) 10 or 25 Best Buy (3%) 25 or 100 Burger King (4%) 10 Build-A-Bear Workshop (8%) 25 California Pizza Kitchen (8%) 10 Burlington Coat Factory (8%) 25 Carl's (5%) 10 Children's Place (12%) 25 Cheesecake Factory (5%) 25 Claire's (9%) 10 Chevy's (8%) 25 Container Store (9%) 25 or 100 Chili's/Macaroni Grill (11%) 25 Crate and Barrel (8%) 25 or 100 Chipotle Mexican Grill (10%) 10 Eddie Bauer (10%) 25 Chuck E. Cheese (8%) 10 Foot Locker (9%) 25 Claim Jumper (9%) 25 GameStop (3%) 25 Coco's (8%) 10 Gap/Navy/Banana Republic (14%) 25 or 100 Coffee Bean & Tea Leaf (9%) 25 Groupon.com (7%) 25 Cold Stone Creamery (8%) 10 Guitar Center (4%) 25 Dave and Buster's (13%) 25 Gymboree (13%) 25 Del Taco (4%) 10 Home Goods (7%) 25 or 100 Domino's Pizza (8%) 10 iTunes (5%) 15 or 25 Einstein Bros. Bagels (10%) 10 J.Crew (13%) 25 Sub Total 1 Sub Total 2 2014-15 - page 2 Denom Qty Total Calculate total # of certificates JoAnn Fabrics (8%) 25 and total dollar value of your order LL Bean (16%) 25 or 100 QTY TOTAL $ Lands' End (16%) 25 or 100 Sub Total 1 Marshalls/TJ Maxx (7%) 25 or 100 Sub Total 2 Michaels (4%) 25 Sub Total 3 Office Depot (4%) 25 or 100 Office Max (5%) 25 or 100 GRAND TOTAL Oriental Trading (9%) 25 Payless Shoes (13%) 20 Pier 1 (9%) 25 Pottery Barn/Wm.Sonoma (8%) 25 or 100 Cash Check # Method of Restoration Hardware (12%) 25 or 100 payment Ross Dress for Less (8%) 25 See's Candies (20%) 18 Sephora (5%) 20 Staples (5%) 25 Talbot's (13%) 25 Toys/Babies R Us (3%) 20 ***Will pick up at (circle one): Dev.Dept. BYH Preschool SPORTING GOODS Big 5 (8%) 25 Dick's Sporting Goods (8%) 25 REI (8%) 25 Sports Authority (8%) 25 GAS STATIONS Important Notes Arco (1.5%) 50 or 100 Arco (2.5%) 250 * Orders must be received by 3:30 p.m. on Chevron (1%) 50 Monday afternoon for Friday pickup! Shell (2.5%) 50 * Make checks payable to "PCS Scrip" Gift Card wrappers - 10 pack (10%) 2 Only Place in Town (20%) 25 Jack's Cleaners (10%) 25 THANKS FOR YOUR SUPPORT !!! Sub Total 3 You may also go to the website www.glscrip.com and look under 'Retailers'. If you find another type of scrip that is not on our order form, you may add it in a blank space and we will order it for you (same is true for other available denominations). *You get one hour of MVP credit for every $250 worth of scrip you order (up to ½ of your required hours)! 8/27/2014.
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