St. Benedict School Scrip Order Form Thank you for supporting St. Benedict School! Please return forms in your Thursday envelope or drop off at the school office. In person sales Please return forms in your Thursday envelope or drop off at the school office. In person days are Wednesday and Friday mornings & after Masses on the 1st and 3rd Sundays each sales days are Wednesday and Friday mornings & after Masses on the 1st and 3rd month. For information, concerns and questions email [email protected] Sundays each month. For information, concerns and questions email [email protected] Family Name: Date: Check # Check Amount: Scrip Gift Certificates Grade: See back of form Certificate number: Date Filled: Order filled by: Purchased by: Given to: Qnty Total Qnty Total Cards in Stock Available Now Dollar Amount $: Date Purchased:

Amazon.com - $100 3% Fainting Goat-$10 15% Qnty Total Qnty Total .com - $25 3% Fainting Goat-$25 15% Cards in Stock Available Now

Amazon.com - $10 3% Gap/OldNvy/BnaRpblc-$25 20% Peet's Coffee & Tea-$20 8% Subway - $10 6%

AMC Theatres - $25 20% Gymboree -$25 13% Pharmaca - $25 15% Subway - $50 6%

American Girl - $25 9% Home Depot - $25 5% Pottery Barn - $25 5% Target - $25 6%

American Girl - $100 9% Home Depot - $100 5% QFC/Fred Meyer - $100 5% Target - $100 6%

Anthony's - $50 10% iTunes - $15 10% QFC/Fred Meyer - $25 5% TJ Maxx/Marshall's - $25 7%

Azteca - $25 15% iTunes - $25 10% QFC/Fred Meyer - $50 5% Walgreens - $25 6%

Barnes & Noble - $10 9% Jack in the Box - $10 4% Red Robin - $25 9% Walgreens - $100 6% Wal-mart/Sam's Club - $25 Barnes & Noble - $25 9% JC Penney - $25 7% Regal Cinemas - $25 8% 2.5% Wal-mart/Sam's Club-$100 Bath & Body Works - $25 13% JC Penney - $100 7% REI Sporting Goods - $25 8% 2.5% Whole Foods - $100 Bed Bath & Beyond - $25 7% Jo Ann Fabrics - $25 8% Ross -$25 8% 3% Whole Foods - $25 Best Buy - $25 3% Lands End $25 9% Safeway - $25 4% 3%

Best Buy - $100 7% L. L. Bean - $25 16% Safeway - $100 4% Zoe Yogurt - $10 10%

Big 5 - $25 8% Lowe's - $100 5% See's Candy - $1 lb $17.50 20% Zoe Yogurt - $25 10%

Burger King - $10 4% Macy's - $25 10% Sephora - $20 5% Qnty Total Cabela's - $25 12% Metropolitan Market - $25 5% Shell Gas - $50 2.5% Chinook Book

California Pizza Kitchen-$10 13% Metropolitan Market - $100 5% Shutterfly - $25 11% Chinook Book $20 50%

Cheesecake Factory - $25 6% Neighborhood Grills**-$10 50% - $5 9% Chinook Book Mobile App $15 50%

Chevron Gas - $50 1% Office Max/ Depot - $100 5% Starbucks - $10 9% Chinook Book Combo $30 50%

Claire's - $10 4% Panera - $10 9% Starbucks - $25 7%

Crate & Barrel - $25 8% Panera - $25 9% Seller notes:

Dennis Uniform - $20 5% Payless Shoes - $20 13%

Eddie Bauer - $25 10% PCC - $25 3%

Neighborhood Bar & Grills: ** Promotional Card, Gratuity not included, whole card/s must be used.

rev 2/18/2015