Name:______Child Name & Grade:______Delivery Method:______Phone:______Date:______Number of cards:______Dollar Amount of Order $______Cards In Stock Cards That Can Be Ordered Grocery/Gas/Stamps Qty FOOD Qty Specialty Stores Qty Clothing Qty Walgreens $ 25 6% $ Applebee's 7% $25 $ Advanced Auto Parts 7% $25 $ Aeropostale 7% $25 $ Walgreens $ 100 6% Baskin Robbins 9% $2 $ Amazon 4% $25 $ American Eagle/Aerie 10% $25 $ BP Gas $ 50 1% $ Boston Market 12% $10 $ AMC Entertainment 7% $25 $ Bass Pro Shop 9% $25 $ Marathon $ 25 3% $ Bonefish 8% $25 $ Auto Zone 8% $25 $ Buckle 8% $25 $ Marathon $ 100 3% $ Bravo 12% $25 $ Barnes N Noble 9% $10 $ Burlington Coat 8% $25 $ Shell $ 25 2% $ Buca di Beppo 8% $25 $ Barnes N Noble 9% $25 $ Cabella's 11% $25 $ Speedway $ 10 5% $ Burger King 4% $10 $ Bath and Body 13% $10 $ Catherines 6% $25 $ Speedway $ 25 5% $ Cheesecake Factory 5% $25 $ Best Buy 3% $25 $ Children's Place 12% $ 25 $ Speedway $ 50 5% $ Cold Stone Creamery 8% $10 $ Build A Bear 10% $25 $ Champs 9% $25 $ Speedway $ 100 5% $ Denny's 7% $10 $ Cinemark 4% $25 $ Claire's 8% $ 10 $ Kroger Re-charge $ 50 3% $ Donatos 10% $10 $ CVS/pharmacy 8% $25 $ Dicks 8% $25 $ Marsh $ 20 5% $ Dunkin Donut 4% $10 $ EB Games 3% $25 $ Disney 2% $25 $ Marsh $ 50 5% $ Hard Rock Café 10% $25 $ Family Christian 9% $25 $ Dots 12% $ 25 $ Postage Stamps $ 8.80 3% $ Hardee's 5% $10 $ Fannie May 25% $10 $ Dress Barn 8% $25 $ Retail Stores Qty Honey baked Ham 12% $25 $ Game Stop 3% $25 $ Express 10% $ 25 $ **Kohls $ 25 5% $ KFC 8% $5 $ GFS Marketpalace 4% $25 $ Fashion Bug 8% $ 25 $ **Kohls $ 100 5% $ Logan's Roadhouse 10% $25 $ Hallmark 5% $25 $ Finish Line 10% $25 $ Meijer $25 3% $ Maggiano's/Macaroni 9% $25 $ iTunes 4% $15 $ Footlocker 9% $25 $ Meijer $50 3% $ Noodle's & Co 8% $10 $ Jiffy Lube 8% $30 $ Gander Mountain 8% $25 $ Meijer $100 3% $ Old Country/Ryan's 5% $25 $ JoAnn Fabrics 6% $25 $ Gap/Old Navy 9% $ 25 $ Target $25 2% $ O'Charley's 13% $25 $ Lowes 4% $25 $ J Crew 13% $ 25 $ Target $100 2% $ Papa Murphy's 8% $10 $ Michaels 4% $25 $ JC Penney 7% $25 $ Wal-Mart/Sams $ 25 2% $ Papa Johns 8% $10 $ Menards 3% $25 $ Journey's 10% $25 $ Wal-Mart/Sams $ 100 2% $ PF Chang's 8% $25 $ Office Max 5% $25 $ KMart 4% $25 $ Restaurant Qty Pizza Hut 8% $10 $ Office Depot 4% $25 $ KMart 4% $100 $ Arby's $ 10 8% $ Qdoba 7% $25 $ Overstock 8% $25 $ Land's End 16% $25 $ Bob Evans $ 10 10% $ Quiznos 10% $10 $ Radio Shack 4% $25 $ Layne Bryant 8% $25 $ Chili's/On The Border$ 25 9% $ Red Robbin 11% $25 $ Shutterfly 9% $25 $ Limited 9% $25 $ Chuck E Cheese $10 8% $ Rock Bottom 6% $25 $ Staples 5% $25 $ LL Bean 15% $25 $ Cracker Barrel $ 10 9% $ Ruth's Chris 10% $50 $ Toys R Us/Baby 1% $20 $ Macy's 10% $ 25 $ Fazoli's $ 25 7% $ Ruby Tuesday's 8% $25 $ Home Depot 4% $25 $ Marshall's/TJ Maxx 7% $25 $ Little Ceasars $ 20 8% $ Starbucks 7% $25 $ Home Depot 4% $100 $ Nike 12% $25 $ Outback/ Carrabas $ 25 8% $ Texas Roadhouse 8% $25 $ Contact Information: Payless 13% $20 $ Panera Bread $ 10 9% $ TGI Friday's 9% $25 $ Rachel Skeens Sears 4% $25 $ Red Lobster/Olive Garden$ 25 9% $ Uno 12% $25 $ Phone: 812-569-2335 Shoe Carnival 5% $25 $ Starbucks $ 10 7% $ Wendy's 4% $10 $ e-mail: [email protected] Steak & Shake $10 8% $ More Cards Available At: Subway $ 10 3% $ www.shopwithscrip.com Scrip Cards available for sale in ** Can be used to pay on Account Taco Bell $ 10 8% $ Enrollment Code school office M, W, & T all day. Order Friday have your cards by next Friday 13ADC6187814