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KW Diving Club SHOP & SUPPORT ORDER FORM

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KW Diving Club SHOP & SUPPORT ORDER FORM KW Diving Club SHOP & SUPPORT ORDER FORM Support KW Diving Club through your everyday shopping, budgeting and gift-giving at over 250 of your favourite retailers. Simply purchase your shopping/gift cards by completing the order form below. ORDER SUBMITTED BY: (FIRST NAME, LAST NAME) DAY TIME TELEPHONE NUMBER: ORDER DEADLINE: January 14, 2009 STUDENT’S OR MEMBER’S NAME: ORDER DATE: For more information please contact: Rosemary Albrechtas, Tel.: (519)744-6664, EMAIL ADDRESS: E-mail: [email protected] EVERYDAY (GROCERY(GROCERY,, PHARMACY & MORE) 49. RAINBOW CINEMA/ MAGIC LANTERN THEATRES * $10 5% 107. GAP / BABY GAP / GAP KIDS $25 5% 1. CADILLAC FAIRVIEW SHOP! CARD: 4000 $26.50 3% 50. ROGERS VIDEO + $10 5% 108. HAKIM OPTICAL $50 10% STORES WITHIN 28 MALLS ( $25 & $1.50 fee) 51. THE SOURCE BY CIRCUIT CITY $25 2% 109. JACOB / GIRLS / CONNEXION / LINGERIE $25 5% 2. CAFÉ DEPOT* $25 3% 52. STAPLES BUSINESS DEPOT ^ + $25/$50/ 3% 110. JEAN MACHINE $25 5% 3. FAIRWAY MARKETS* $50 3% $100/$250 111. LA SENZA / LA SENZA GIRL+ $25 5% 4. GIANT TIGER $25/$100 3.5% 53. SUNRISE RECORDS + $25 10% 112. LA VIE EN ROSE / AQUA $25 5% 113. LE CHATEAU $25 5% 5. LOBLAWS / NO FRILLS / FORTINO’S / SAVE $25/$50/ 3% HOUSE & HOME 114. MARK’S WORK WEARHOUSE $25/$100 6% EASY / VALUMART/ ZEHRS / MAXI / EXTRA $100/$250 54. THE BRICK / BRICK MATTRESS STORE ^ $100/$500/ 1.5% $1000 115. MOORES: THE SUIT PEOPLE $25 5% FOODS / INDEPENDENT / GREAT CANADIAN 55. BRAULT & MARTINEAU* $50/$100/ 1.5% 116. NORTHERN REFLECTIONS + $25 3% WHOLESALE / SUPERSTORE / SUPERVALUE / $500 117. OLD NAVY $25 6% PROVIGO 56. CANADIAN TIRE ^ + $10/$25/ 4% 118. PAYLESS SHOESOURCE $25 5% 6. **NEW** LOEB* $10/$25 3% $50/$100 119. ROOTS / ROOTS KIDS / HOME $25 15% 7. LONDON DRUGS $25/$100 1.5% HOME DEPOT ^ $50/$100/ 2% 57. 120. RUNNING ROOM $25 5% 8. LONGO'S SUPERMARKETS $25/$50/ 3% $250/$1000 121. SIBLINGS $25 5% $100/$250 58. HOME HARDWARE / FURNITURE ^ $25/$50/ 3.5% SIRENS $25 5% 9. **NEW** METRO ONTARIO/A&P / DOMINION / $25/$50/$100 3% $100/$1000 122. STITCHES $25 5% THE BARN / ULTRA 59. HOME OUTFITTERS ^ + $25/$50/$100 3% 123. 124. SUNGLASS HUT / WATCH STATION $25 5% 10. METRO QUEBEC / SUPER C $25 2% 60. HOMESENSE $25/$50/$100 5% 125. SUZY SHIER + $25 5% M & M MEAT SHOPS + 61. KENT BUILDING SUPPLIES ^ $50/$100 1.5% 11. $10/$25 3% 126. THE SHOE COMPANY *+ $25 5% 62. LEON’S FURNITURE * ^ $100 2% 12. PHARMA PLUS / REXALL + $25/$100 5% 127. TIP TOP TAILORS / GRAFTON & CO / MR BIG & $25 5% 13. PUSATERI'S FINE FOODS $25/$100 3% 63. LINENS N THINGS $25/$100 5% TALL / STONEHOUSE / GEORGE RICHARDS 14. SAQ $25/$100 2% 64. PIER 1 IMPORTS ^ $25/$100 5% 128. TOMMY HILFIGER $25 10% 15. SHOPPERS DRUG MART + $25/$50/$100 3% 65. POTTERY BARN / PB KIDS/ WILLIAMS-SONOMA $25/$100 5% 129. TOWN SHOES * $50 5% 16. SOBEYS / IGA / PRICE CHOPPER / FOODLAND / $10/$25/$50 3% 66. RONA / BOTANIX / TOTEM BUILDING +^ $50/$100/$500 3% 130. TRANSIT SHOES / SPRING $25 5% FOOD TOWN / COMMISSO'S / NEEDS / 67. SEARS HOME ^ $25/$50/ 3% 131. URBAN PLANET $25 5% LAWTONS DRUG STORES / BONICHOIX * $100/$500 132. WEST 49 $25 5% 17. STARBUCKS $25 5% RESTAURANTS & FINE DINING 133. WINNERS $25/$50/$100 5% 18. T&T SUPERMARKETS $20/$50/$100 2% 68. APPLEBEE'S GRILL & BAR $25 10% SPORTING & OUTDOOR 19. TIMOTHY'S COFFEE $25 5% 69. **NEW** BOSTON PIZZA $25/$50/$100 5% 134. BASS PRO SHOPS $25 5% 20. ZELLERS ^ + $25/$50/$100 3% 70. BURGER KING $25 5% 135. GOLF TOWN $50 3% GAS, AUTOMOTIVE & CONVENIENCE 71. **NEW** CACTUS CLUB CAFE $25 5% 136. NATIONAL SPORTS / SPORTS EXPERTS / $25 1.5% CANADIAN TIRE / GAS BAR ^ + $10/$25/ 4% 21. 72. CARA / KELSEY’S / MONTANA’S / MILESTONE’S $25/$50/$100 3% ATMOSPHERE / INTERSPORT / RnR * $50/$100 / SWISS CHALET / HARVEY’S 137. SPORT CHEK / COAST MOUNTAIN SPORTS + $25 5% 22. ESSO ^ + $25/$50/$100 2% 73. CRABBY JOE’S TAP & GRILL * $25 5% 138. SPORT MART $25 5% 23. **NEW** NORTH ATLANTIC PETROLEUM $25/$50/$100 1.5% 74. EARLS RESTAURANT $25 5% 139. SPORTING LIFE $25 5% 24. FASGAS $20 1.5% 75. EAST SIDE MARIO’S / CASEY’S / PRIME PUBS $25 5% 140. TORONTO BLUE JAYS $25 5% 25. PETRO-CANADA GIFT CARD ^ + $25/$50/$100 2% 76. HARVEY’S $25/$50/$100 3% SPECIALTY RETAIL 26. PETRO-CANADA PREFERRED PRICE CARD+ $47.50 5% 77. IL FORNELLO RESTAURANTS $25 5% 141. BEN MOSS JEWELLERS $25/$100 5% SAVE 5 CENTS/LITRE. USE WITH A GIFT CARD 78. JACK ASTOR’S / ALICE FAZOOLI’S / REDS / $25/$100 10% 27. PIONEER PETROLEUM *+ $25/$100 1.5% CANYON CREEK / FAR NIENTE 142. BIRKS * $100 5% 28. RACE TRAC $20 1.5% 79. KEG RESTAURANTS $25/$50/$100 5% 143. THE BODY SHOP + $25 5% 144. CRABTREE & EVELYN *+ $25 10% 29. SHELL / TURBO / BEAVER / PAYLESS *+ $20 1.5% 80. KERNELS EXTRAORDINARY POPCORN $10/$25 5% 145. FRUITS AND PASSION $25 5% 30. **NEW** SUNOCO $20/$50/$100 1.5% LAURA SECORD $10/$25 10% 81. 146. GNC + $25 4% 31. ULTRAMAR $25/$50/$100 2% 82. LICK’S HOMEBURGER $25 5% 147. LUSH FRESH HANDMADE COSMETICS $25 10% DEPARTMENT STORE 83. MOXIE’S CLASSIC GRILL $25 10% 148. **NEW** MAPPINS JEWELLERS $25/$100/500 5% 32. HBC / THE BAY ^ + $25/$50/$100 3% 84. OLIVER & BONACINI GRILL / CANOE / JUMP / $50 5% 149. **NEW** PEOPLES JEWELLERS $25/$100/500 5% 33. SEARS ^ $25/$50/$100/ 3% AUBERGE DU POMMIER / BIFFS 150. PETCETERA *+ $10 5% 85. PIZZA PIZZA (BOOK of 5 x $5) * $25 10% $500 151. REGIS SALONS/BEAUTY EXPRESS/ BORICS/ $25 5% 86. PIZZA 73 (BOOK of 5 x $5) * $25 5% BOOKS, ELECTRONICS & ENTERTAINMENT HAIRMASTERS/MASTERCUTS/TRADE SECRET 87. RED LOBSTER / OLIVE GARDEN $25 5% 34. AMC THEATRES $12 20% 152. SCHOLAR’S CHOICE $25 5% 88. **NEW** RED ROBIN $25 5% 35. AMAZON.CA $25 4% 153. TOYS R US $25/$50/$100 2% 89. ST-HUBERT $20 5% 36. ARCHAMBAULT $25 5% 154. **NEW** WAYSPA $25 5% 90. SUBWAY $25 3% 37. BEST BUY ^ $25/$50/$100/ 2% TRAVEL $250/$1000 91. TOPPER’S PIZZA $25 10% 155. AIR CANADA VACATIONS* (redeemable at any $100/$500 3% 38. BLACK'S PHOTO + $25/$50 5% 92. WENDY’S $25 3% travel agent towards ACV Canada vacation /$1000 39. BLOCKBUSTER + $10 5% 93. WHITE SPOT RESTAURANTS $25 5% packages) 40. EB GAMES $25 3% FASHION & ACCESSORIES 156. **NEW**AVIS $25/$100 5% CINEPLEX / FAMOUS / GALAXY CHILD NIGHT $15 15% 41. 94. ALDO SHOES/ALDO KIDS $25 5% 157. BEST WESTERN HOTELS + $50 5% (up to $18 value- w/popcorn/drink/treat) 95. AMERICAN EAGLE OUTFITTERS + $25 5% 158. **NEW**BUDGET $25/$100 5% CINEPLEX / FAMOUS PLAYERS / GALAXY $30 10% 42. 96. BANANA REPUBLIC $25 5% 159. FAIRMONT HOTELS $100 5% ADULT NIGHT OUT (up to $42.50 value--w/2 97. BLUENOTES $25 5% 160. MARRIOTT HOTELS *+ $50 5% admissions/2 drinks/1 popcorn) 98. BOATHOUSE $25 5% 161. SEARS TRAVEL ^ $25/$50/ 3% 43. CINEPLEX / FAMOUS PLAYERS / GALAXY CARD $10 5% 99. BOOTLEGGER $25 5% $100/$500 44. CINEPLEX / FAMOUS PLAYERS / GALAXY $10 10% 100. CAMPUS CREW $25 5% 162. SIGNATURE VACATIONS* (redeem directly $100/$500/ 5% ADMIT ONE ADULT CERT * (up to $12.50 value) CHAMPS SPORTS $25 5% through Signature – 1-888-252-5436) $1000 45. FUTURE SHOP ^ $25/$50/$100/ 2% 101. 163. TRAVELODGE HOTELS + $75 5% $250/$1000 102. COTTON GINNY $25 5% 164. VIA RAIL + $25/$100 2.5% 46. HENRY'S CAMERAS $50 2% 103. DANIER LEATHER $100 5% 165. WESTJET *+ $50 3% 47. HMV $25 2% 104. EDDIE BAUER $25 7% 48. MOVIE GALLERY(BOOK of 5 x $5) * $25 5% 105. FEET FIRST $25 5% 106. FOOT LOCKER $25 5% NO. SHOP AND SUPPORT CARD SELECTED VALUE QUANTITY $ TOTAL NO. SHOP AND SUPPORT CARD SELECTED VALUE QUANTITY $ TOTAL TOTAL TOTAL AUTHORIZED SIGNATURE PLEASE INDICATE HOW YOU WOULD LIKE TO RECEIVE YOUR ORDER: TOTAL AMOUNT ENCLOSED: PLEASE HOLD ORDER PLEASE RELEASE ORDER FOR PICKUP TO DESIGNATE $ AUTHORIZATION FOR RELEASE: I AUTHORIZE KW Diving Club TO PAYMENT AND DELIVERY TERMS: RELEASE MY GIFT CARDS AND CERTIFICATES DIRECTLY TO MY PLEASE MAKE ALL CHEQUES PAYABLE TO KW Diving Club. ATTACH CHEQUE TO COMPLETED ORDER FORM AND RETURN TO KW Diving Club IMMEDIATELY DESIGNATE. I WILL NOT HOLD KW Diving Club RESPONSIBLE FOR ANY FOR PROMPT PROCESSING. ALL ORDERS WILL BE AVAILABLE FOR PICK-UP BY THE AUTHORIZED PERSON NAMED ON THIS FORM. DENOMINATIONS MAY LOST OR STOLEN GIFT CARDS OR CERTIFICATES. BE SUBSTITUTED AS REQUIRED TO COMPLETE EACH ORDER . ALL ORDERS ARE SUBJECT TO AVAILABILITY. SYMBOL KEY: * ONLY AVAILABLE AS A PAPER CERTIFICATE / ^ CANNOT BE USED TO MAKE PAYMENTS ON ACCOUNT / + EARN IN-STORE REWARDS RRRARAAAIIIISSSSEEEE FFFUFUUUNNNNDDDDSSSS FFFOFOOORRRR KKKWKWWW DDDiDiiivvvviiiinnnngggg CCClCllluuuubbbb EEEVEVVVEEEERRRRYYYYDDDDAAAAYYYY WWWIWIIITTTTHHHH SSSHSHHHOOOOPPPPAAAANNNNDDDDSSSSUUUUPPPPPPOOOORRRRTTTT....CCCCAAAA!!!! ©2008 Preferred One Inc. All rights reserved. Shop & Support is a trademark of Preferred One Inc. REV. 12/08 .
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