Scrip Standing Order Form

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Please verify your order and let us know of any discrepancies immediately by e-mailing us at [email protected] PLEASE RETURN EMPTY ENVELOPES Name: FOR NEXT STANDING ORDER Card Quantity Card Quantity Card Quantity BP $50 Amazon.com $25 Applebee's $25 BP $100 Barnes & Noble $25 Applebee's $50 Exxon/Mobil $50 CVS/pharmacy $25 Buffalo Wild Wings $25 Kwik Trip $25 GNC $25 Chili's/Maggiano's $25 Kwik Trip $50 Klinke $25 Cousins Subs $10 Kwik Trip $100 Kohl's $25 Culver's $10 PDQ $50 Kohl's $100 Culver's $25 PDQ $100 Land's End $25 Denny's $10 Good Harvest $25 Marcus $10 Noodles & Company $10 Good Harvest $100 Marcus $25 Olive Garden/Red Lobster $25 Meijer $25 Target $25 Outback/Carraba's $25 Meijer $50 Target $50 Panera Bread $10 Meijer $100 Target $100 Panera Bread $25 Pick N Save $25 Walgreen's $25 Papa Murphy's $10 Pick N Save $50 Walmart/Sam's $25 Starbucks $10 Pick N Save $100 Walmart/Sam's $100 Starbucks $25 Piggly Wiggly $25 Walmart/Sam's $250 Subway $10 Piggly Wiggly $50 Sendik's - Balistreri $25 Sendik's - Balistreri $100 Sendik's - Brookfield $100 Sentry $10 Sentry $50 Stop & Shop/Peapod $100 Woodman's $50 Woodman's $100 Order Total $ Thank you for your support of this great fundraiser!! Please verify your order and let us know of any discrepancies immediately by e-mailing us at [email protected] PLEASE RETURN EMPTY ENVELOPES Name: FOR NEXT STANDING ORDER Card Quantity Card Quantity Card Quantity BP $50 Amazon.com $25 Applebee's $25 BP $100 Barnes & Noble $25 Applebee's $50 Exxon/Mobil $50 CVS/pharmacy $25 Buffalo Wild Wings $25 Kwik Trip $25 GNC $25 Chili's/Maggiano's $25 Kwik Trip $50 Klinke $25 Cousins Subs $10 Kwik Trip $100 Kohl's $25 Culver's $10 PDQ $50 Kohl's $100 Culver's $25 PDQ $100 Land's End $25 Denny's $10 Good Harvest $25 Marcus $10 Noodles & Company $10 Good Harvest $100 Marcus $25 Olive Garden/Red Lobster $25 Meijer $25 Target $25 Outback/Carraba's $25 Meijer $50 Target $50 Panera Bread $10 Meijer $100 Target $100 Panera Bread $25 Pick N Save $25 Walgreen's $25 Papa Murphy's $10 Pick N Save $50 Walmart/Sam's $25 Starbucks $10 Pick N Save $100 Walmart/Sam's $100 Starbucks $25 Piggly Wiggly $25 Walmart/Sam's $250 Subway $10 Piggly Wiggly $50 Sendik's - Balistreri $25 Sendik's - Balistreri $100 Sendik's - Brookfield $100 Sentry $10 Sentry $50 Stop & Shop/Peapod $100 Woodman's $50 Woodman's $100 Order Total $ Thank you for your support of this great fundraiser!!.

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Targeted Investment Areas
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Onalaska West Salem Holmen
g g s s n n i i e e h h r r e e i i r r c c a a u u g g . a a n n h h n n g g b b F F g g u u S S e e e e u u n n r r L L l l I I V V e e e e e e l l M M / / l l C C l l t t é é Onalaska n West Salem n t t a a s s r r a a i i h h o o 0 0 t t c c d d u u g g i i m m h h 0 0 n n i i o o r r 5 5 L S K F L S K F L L P E P E Applebee’s Breakers 9364 State Road 16, Onalaska, WI 54650 608.781.8570 ## ### 153 Leonard Street South, West Salem, WI 54669 608.786.9999 ### # Blue Moon, 716 2nd Ave N, Onalaska, WI 54650 608.781.6800 ## # # Coney Island, 83 Buol Rd, West Salem, WI 54669 608.786.0762 ### ## Brice Prairie Pub & Eatery Features Sports Bar & Grill N5914County Highway Zz Onalaska, WI 54650 608.781.4141 ## ### 1425 W City Hwy 16, West Salem, WI 54669 608.786.4045 ### ## Buffalo Wild Wings Lindas Café 3132 Market Place, Onalaska, WI 54650 608.781.9453 ####W4007 County Highway O, West Salem, WI 54669 608.786.0571 ## ## Burger King Maple Grove ## # 1259 Crossing Meadows Dr, Onalaska, WI 54650 608.781.6101 ## ## W4142 County Road B , West Salem, WI 54669 608.786.1500 ## ## Burrachos Quiznos, 83 Buol Rd, West Salem, WI 54669 608.786.2703 Subway , 420 Commerce St, West Salem, WI 54669 608.786.2225 ## ## 9432 State Road 16 # 100A, Onalaska, WI 54650 608.781.5900 ### # Pizza Villa, 156 Leonard St S, West Salem, WI 54669 608.786.2515 ### Carlos O’Kelly’s Top Dawgs Pub & Grub ###### 9396 State Road 16, Onalaska, WI 54650 608.783.1782 N8292 State Road 108, Mindoro WI 54644 608.857.3077 ### # Cedar Creek Village Inn 2600 Cedar Creek Ln, Onalaska, WI
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