Scrip Order Form

St. Thomas Aquinas SCRIP ORDER FORM Thank you! Your support is greatly appreciated! Please remember that we can sell only the amounts listed on the order form. Name:_______________________________________________Phone:___________________Date:_______________ Check# :_________________Amount:__________________ * Please make checks payable to: St. Thomas Aquinas * Filled by__________NEEDS:________________________________________________________________________ Retailer Profit Card Qty. Total Retailer Profit Card Qty. Total (c.o.a.) = certificate on account for Amount (c.o.a.) = certificate on for Amount school account school $5.00 $100 Claire’s $0.90 $10 All Seasons Gutter/New All Seasons Gutter/Topper $10.00 $100 Cold Stone $0.80 $10 Creamery American Eagle Outfitters $2.00 $25 Courtyard/Marriott $6.00 $50 Applebees $2.00 $25 Critter $0.50 $10 Nation(Dyvig’s) Arby’s $0.80 $10 Barnes & Noble/B. Dalton $1.00 $10 Derry Auto (c.o.a.) $1.00 $25 Barnes & Noble/B. Dalton $2.50 $25 Derry Auto (c.o.a.) $2.50 $50 Bath and Body Works $1.30 $10 Derry Auto (c.o.a.) $5.00 $100 Bath and Body Works $3.25 $25 Dillard’s $2.25 $25 Bed, Bath and Beyond $1.75 $25 Dress Barn $2.00 $25 Best Buy $0.50 $25 Express $2.50 $25 Best Buy $2.00 $100 Fareway $0.50 $25 Big Time Cinema (Fridley’s) $1.00 $10 Fareway $1.00 $50 Borders/Waldenbooks $0.90 $10 Fareway $2.00 $100 Borders/Waldenbooks $2.25 $25 Fairfield Inn/Marriott $6.00 $50 Build-A-Bear $2.00 $25 Fazoli’s $1.75 $25 Burger King $0.50 $10 Finish Line $2.50 $25 Cabela’s $3.25 $25 Flower Cart (c.o.a.) $1.25 $25 Carlos O’Kelly $0.90 $10 Foot Locker $2.25 $25 Casey’s $0.30 $10 Fuhs Pastry $1.00 $10 Casey’s $0.75 $25 Gap/Old $2.25 $25 Navy/Banana Republic Casey’s $1.50 $50 GameStop $0.75 $25 Cheesecake Factory $1.25 $25 Gerber’s (c.o.a.) $2.50 $50 Chili’s/Macaroni Grill/On the $2.75 $25 Gerber’s (c.o.a.) $5.00 $100 Boarder Chuck E. Cheese $0.80 $10 Gilbert Jewelry $2.50 $25 (c.o.a.) Chuong Garden $6.00 $30 Gilbert Jewelry $7.50 $75 (c.o.a.) GNC $2.00 $25 Scrip Order Form Continued Gymboree (Children’s $3.25 $25 Panera Bread $0.90 $10 Clothing) Hard Rock Cafe $2.50 $25 Pampered Chef $3.75 $25 (Mary Frankhauser) Heart-N-Home $1.00 $10 Payless Shoes $2.60 $20 Home Appliance $0.50 $25 Pier 1 Imports $2.25 $25 Home Appliance $2.00 $100 PF Chang China $1.75 $25 Bistro Home Depot $0.75 $25 Pizza Hut $0.90 $10 Home Depot $3.00 $100 Pottery $2.00 $25 Barn/Williams Sonoma Hyatt Hotels $2.25 $25 Romancing the $1.50 $15 Home Hy-Vee $0.20 $10 Sally Beauty Co. $3.00 $25 Hy-Vee $0.50 $25 Saloon Pizza – eat $2.10 $10.60 in/carry out lrge 2 topping only Hy-Vee $1.00 $50 Sears $1.75 $25 Hy-Vee $2.00 $100 Sears $7.00 $100 Iowa Meat Shop (Scott Rector) $10.00 $50 Sears $17.50 $250 Iowa Meat Shop (Scott Rector) $20.00 $100 Second St. $1.00 $10 Emporium J. Crew $3.25 $25 Second St. $2.00 $20 Emporium J.C. Penny $1.50 $25 Second St. $3.00 $30 Emporium J.C. Penny $6.00 $100 Shoe Carnival $1.25 $25 Jo-Ann Fabrics $1.20 $20 Shoppers Supply $1.25 $25 K Mart $1.00 $25 Shoppers Supply $2.50 $50 K Mart $2.00 $50 Shoppers Supply $25.00 $500 Kentucky Fried Chicken $0.45 $5 Shutterfly $3.50 $25 Kohl’s $1.00 $25 Sport s World $1.50 $15 Kohl’s $4.00 $100 Sports World $2.00 $20 Kum & Go $0.50 $10 Staples $2.00 $25 Kum & Go $1.25 $25 Starbucks $.070 $10 Kum & Go $2.50 $50 Subway $0.30 $10 Land’s End $3.00 $25 Ted’s Carwash 5 - $5.00 $35 $5.00 washes Laser Car Wash (5 at option $5.00 $35 T.J. Maxx/ Marshalls $1.75 $25 #2) Leon’s $1.00 $10 Toys-R-Us/Kids-R- $0.20 $20 Us/Babies-R-Us Limited (The Limited) $2.25 $25 VISA Prepaid card $0.50 $25 Long John Silver’s $0.45 $5 Visa Prepaid card $1.00 $50 Lowes (also avail. in $100 & $1.00 $25 Visa Prepaid card $2.00 $100 $500) Maurices $1.40 $20 Walgreens $0.40 $20 Menards $0.75 $25 Wal-Mart $0.50 $25 Menards $3.00 $100 Wal-Mart $2.00 $100 Office Max $1.25 $25 Wendy’s $0.90 $10 Olive Garden/Red Lobster $2.25 $25 Williams Drug $0.30 $10 Osweilers $2.00 $20 Younkers/Carson $2.00 $25 Pirie Outback Steakhouse $1.25 $25 Younkers/Carson $8.00 $100 Pirie Old Chicago/ Rock Bottom $1.50 $25 Questions: Call Erin Please look at our list of other Tasler cards! 832-4171 .

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