Corpus Christi SCRIP Order Form (last revision 2/20)

Dis- Denomi- Dis- Denomi- Qty Cost Qty Cost Merchant count nation Merchant count nation

Grocery Papa Murphy’s 8% $10 5% $25 Hut* 8% $10 Hy-Vee 5% $100 Pizza Ranch 8% $25 4% $25 Potbelly Shop 8% $10 Jewel-Osco (R) 4% $100 * 8% $25 Kroger 4% $100 * (R) 8% $25 3% $25 10% $10 Meijer (R) 3% $100 7% $5 Gas Stations * (R) 7% $10 BP (R) 1.5% $50 7% $25 Circle K 1.5% $25 Steak ‘n Shake* 8% $10 Shell (R) 1.5% $25 6% $10 (R) Restaurants 6% $50 Applebee’s* 8% $25 Bell 5% $10 Arby's 8% $10 TGI Friday's* 9% $25 10% $10 Avanti’s Wendy’s 6.5% $10 10% $25 Retail Stores Blaze Pizza* 10% $25 AB Hatchery 10% $10 Binny’s 3% $25 AMC Theatres* 8% $25 Bob Evans* 10% $10 Advance Auto Parts 7% $25 8% $10 Buffalo Wild Wings* (R) Aeropostle* (R) 10% $25 8% $25 2.25% $10 Amazon.com* * (R) 4% $10 2.25% $25 Carl’s 20% $10 American Girl 9% $25 Chili’s* 11% $25 Altitude Trampoline (1 hr pass) 33% $15 10% $10 Chipotle* Auto Zone 7% $25 10% $25 8% $5 Chuck E. Cheese* 8% $10 Barnes & Noble* 8% $10 11% $5 * 8% $25 11% $10 Bass Pro Shops* 10% $25 Cracker Barrel* 8% $25 Bath & Body Works / 12% $10 Culver’s 10% $10 White Barn Candle Co* (R) 12% $25 3% $10 Bed Bath & Beyond 7% $25 Denny's 7% $10 4% $25 Best Buy* Domino’s Pizza* 8% $10 4c% $100 3% $10 Dunkin’ Donuts Build-A-Bear Workshop* 8% $25 3% $25 Children’s Place* 12% $25 Einstein Bros. Bagels 10% $10 CVS Pharmacy* (R) 6% $25 Fazoli’s* 9% $25 Dick's Sporting Goods 8% $25 Firehouse Pizza 20% $25 Disney* 3% $25 Great Harvest Bread Co. 6% $10 DSW* 8% $25 Happy Dining 18% $25 Dwelling Place 10% $25 IHOP* 8% $25 Express* 10% $25 Joe’s Station House 10% $25 Fandango* 4% $25 Doughnuts 8% $10 Fannie May Candies 25% $10 La Gondola 15% $10 Family Video 12% $10 Pizza 8% $20 Footlocker Stores* 9% $25 Meatheads 20% $20 Gap* (R) 14% $25 Monical's Pizza 10% $10 GNC 8% $25 Noodles & Company 8% $10 Growing Grounds 10% $25 Oberweis 8% $10 Hallmark* (R) 4% $25 Olive Garden* (R) 8% $25 4% $25 Home Depot* Original Pancake House 20% $25 4% $100 * 8% $25 5% $15 iTunes* 8% $5 5% $25 * (R) 8% $10 Jo-Ann Fabrics 6% $25 8% $25 4% $25 Kohl's* Papa John’s* (R) 9% $10 4% $100 Land’s End* 15% $25 SCRIP Gift Certificate 4% $25 To: Lowe's* (R) 4% $100 From: Macy’s 10% $25 SCRIP Gift Certificate Amount: 3% $25 To: Menards 3% $100 From: Michael’s 4% $25 SCRIP Gift Certificate Amount: Nike* 12% $25 Nordstrom* 4% $25 Name ______Office Depot 5% $25

(R) 14% $25 Old Navy* Oshkosh/Carter’s (R) 10% $25 Phone Number ______Petsmart 5% $25 Sally's Beauty Supply 12% $25 Scheel’s* 8% $25 SCRIP Delivery Preference Shoe Carnival 5% $25 Shoe Dept. Encore 8% $25 Send home with student 2.5% $10 Target* (R) 2.5% $25 Child’s name: ______T J Maxx / Home Goods* 7% $25 Ulta 4% $25 Teacher’s name: ______

Under Armour* 11% $25 Pickup in school office after 12:00 PM Thursday Walgreens 5% $25

2.5% $25 Walmart / Sam’s Club* (R) Office Use Only 2.5% $100 Hotels Filled Comfort Inn 3% $100 Comfort Suites 3% $100 Scheduled

Fairmont Hotels 9% $100 Partial Fill: ______Quality Inn (R) 3% $50 Travel ______Avis 8% $50 Budget 8% $50 Carnival Cruise Lines* 8% $100 Delta Airlines* 4% $250 Gift Cards

Discover 1.25% $50

Visa Five Back 1.25% $50

TOTAL SCRIP ORDER AMOUNT DUE

Volunteer Initials ______Check # ______

• Bold - cards are in stock • * - available with ScripNow

• (R) - able to reload gift card at shopwithscrip.com (Add funds to existing gift cards purchased through our program)

Additional Information:

• Please contact SCRIP coordinators with any questions: Rogucki (480-292-0776) and Gina O’Brien (626-487-4981), [email protected] • Make checks payable to Corpus Christi Catholic School • For a complete list of retailers and to order directly visit www.shopwithscrip.com • All order forms must be submitted by 8:00 A.M. each Tuesday. Forms received after 8:00 A.M. will be held until the following week.