Family Order Form Created: 11/15/2016 1:38:25 AM Central Elementary School PTO Orders are DUE no later than December 6th. Orders must be paid in full with cash or checks when they are submitted. Gift cards will be sent home in child's backpacks by Dec. 16th. Questions? Contact PTO: [email protected]

Name Customer #

Check # Order Date

Clothing & Accessories Dining - Casual Dining - Fine Product % QTY Total Product % QTY Total Product % QTY Total American Eagle 10% $ Applebee's® $25.00 8% $ Pei Wei Asian Diner 8% $ Outfitters $25.00 $25.00 Bob Evans $10.00 10% $ Buckle $25.00 8% $ Dining - On The Go Buffalo Wild Wings 8% $ Carter's $25.00 10% $ $10.00 Product % QTY Total Children's Place $25.00 12% $ Buffalo Wild Wings 8% $ Arby's $10.00 8% $ $25.00 Claire's $10.00 9% $ $10.00 4% $ Pizza Kitchen 8% $ Dressbarn $25.00 8% $ $25.00 10% $ Chevy's Fresh Mex 8% $ $10.00 Famous Footwear 8% $ $25.00 $10.00 3% $ $25.00 Chili's Grill & Bar $25.00 11% $ Foot Locker $25.00 9% $ Domino's $10.00 8% $ Chuck E. Cheese 8% $ Dunkin' Donuts $10.00 3% $ Gap $25.00 14% $ $10.00 Gymboree $25.00 13% $ Cracker Barrel $10.00 9% $ Dunkin' Donuts $25.00 3% $

HomeGoods $25.00 7% $ Cracker Barrel $25.00 9% $ Fazoli's $25.00 7% $

Icing $10.00 9% $ Darden® 9% $ Goodcents Deli Fresh 12% $ $25.00 Subs $10.00 J. Crew $25.00 13% $ Denny's $10.00 7% $ Hardee's $10.00 5% $

L.L.Bean $25.00 16% $ IHOP $10.00 8% $ $10.00 4% $

Limited $25.00 9% $ IHOP $25.00 8% $ Little Caesar's Pizza 8% $ $20.00 Marshalls $25.00 7% $ LongHorn Steakhouse 9% $ Long John Silver's 8% $ ® $25.00 Old Navy $25.00 14% $ $10.00 Maggiano's Little Italy 11% $ $10.00 9% $ OshKosh $25.00 10% $ $25.00

Payless Shoes $20.00 13% $ Mimis Cafe $25.00 8% $ Panera Bread $25.00 9% $

Shoe Carnival $25.00 5% $ Noodles & Company 8% $ Panera Bread $5.00 9% $ $10.00 T.J. Maxx $25.00 7% $ Papa John's Pizza 8% $ O'Charley's $25.00 13% $ $10.00 T.J. 7% $ Olive Garden ® $25.00 9% $ Papa Murphy's Pizza 8% $ Maxx/Marshalls/HomeG $10.00 oods $25.00 8% $ (Not AK or HI) 8% $ $10.00 Talbots $25.00 13% $ $10.00 Outback Steakhouse 8% $ Mexican Grill 7% $ Under Armour $25.00 11% $ $25.00 $25.00 $25.00 8% $ Department Store $10.00 10% $ ® $25.00 9% $ Product % QTY Total $10.00 7% $ Boston Store $25.00 8% $ $25.00 9% $ Starbucks $25.00 7% $ jcpenney $25.00 5% $ Ruby Tuesday $25.00 8% $ Steak 'n Shake $10.00 8% $ Kohl's $25.00 4% $ Roadhouse 8% $ ® Restaurants 6% $ $25.00 Macy's $25.00 10% $ $10.00 TGI Fridays $25.00 9% $ SUBWAY® Restaurants 6% $ Nordstrom $25.00 6% $ Dining - Fine $50.00 Sears $25.00 4% $ $10.00 5% $ Product % QTY Total Wendy's $10.00 4% $ P.F. Chang's China 8% $ Bistro $25.00

Make Checks Payable To: Central Elementary PTO Total Due All Columns: $ Family Order Form Created: 11/15/2016 1:38:25 AM Central Elementary School PTO Orders are DUE no later than December 6th. Orders must be paid in full with cash or checks when they are submitted. Gift cards will be sent home in child's backpacks by Dec. 16th. Questions? Contact PTO: [email protected]

Name Customer #

Check # Order Date

Discount Store Gas & Auto Online & Catalog Product % QTY Total Product % QTY Total Product % QTY Total Burlington Coat Factory 8% $ Jiffy Lube $30.00 8% $ Amazon.com $10.00 3% $ $25.00 Mobil $50.00 1% $ Amazon.com $25.00 3% $ Gordmans $25.00 7% $ Shell $25.00 2% $ Groupon.com $25.00 7% $ Sam's Club $25.00 2.5% $ Shell $50.00 2% $ iTunes® $15.00 5% $ Target $10.00 2.5% $ iTunes® $25.00 5% $ Target $25.00 2.5% $ Grocery Product % QTY Total Nike $25.00 12% $ Target $50.00 2.5% $ Dierbergs $25.00 2.5% $ Overstock.com $25.00 8% $ Walmart $100.00 2.5% $ Gordon Food Service 4% $ Shutterfly $25.00 9% $ Walmart $25.00 2.5% $ Store $25.00 Zappos.com $25.00 8% $ Electronics & Office Shop 'N Save (IL and 4% $ MO only) $10.00 Specialty Retailer Product % QTY Total Shop 'N Save (IL and 4% $ Best Buy® $25.00 4% $ MO only) $25.00 Product % QTY Total Whole Foods Market 3% $ American Girl $25.00 9% $ GameStop $25.00 3% $ $25.00 Babies"R"Us $20.00 3% $ Office Depot / Office 5% $ Health & Beauty Max $25.00 Product % QTY Total Build-A-Bear Workshop 8% $ Staples $25.00 5% $ $25.00 Bath & Body Works 13% $ Container Store $25.00 9% $ Entertainment $10.00 Hallmark $25.00 4% $ Product % QTY Total Bath & Body Works 13% $ $25.00 AMC Theatres® $10.00 8% $ Honey Baked Ham 12% $ CVS Pharmacy $10.00 6% $ $25.00 AMC Theatres® $25.00 8% $ CVS Pharmacy $25.00 6% $ Jo-Ann Fabric and Craft 6% $ Stores $25.00 Barnes & Noble $10.00 9% $ GNC $25.00 8% $ Michaels $25.00 4% $ Barnes & Noble $25.00 9% $ Great Clips $25.00 8% $ Oriental Trading 9% $ Company $25.00 Barnes & Noble $5.00 9% $ Sally Beauty Supply 12% $ $25.00 PetSmart $25.00 4% $ Dave & Buster's $25.00 13% $ Sephora $20.00 5% $ Tanger Outlets $25.00 8% $ Fandango $25.00 4% $ ULTA $25.00 4% $ Toys"R"Us $20.00 3% $ NOOK by Barnes & 9% $ Noble $10.00 Walgreens $25.00 6% $ Sporting Goods NOOK by Barnes & 9% $ Home Decor Noble $25.00 Product % QTY Total Regal Theatres $25.00 8% $ Product % QTY Total Bass Pro Shops $25.00 9% $

Gas & Auto Bed Bath & Beyond 7% $ Cabela's $25.00 11% $ $25.00 Product % QTY Total Pier 1 Imports $25.00 9% $ Dick's Sporting Goods 8% $ $25.00 Advance Auto Parts 7% $ Pottery Barn $25.00 8% $ $25.00 Gander Mountain 8% $ $25.00 AutoZone $25.00 8% $ Home Improvement REI $25.00 8% $ BP $50.00 1.5% $ Product % QTY Total Travel Chevron $50.00 1.5% $ Lowe's $25.00 4% $ Product % QTY Total Circle K $25.00 1.5% $ Menards $25.00 3% $ Disney $25.00 2% $ Exxon $50.00 1% $ The Home Depot 4% $ $25.00

Make Checks Payable To: Central Elementary PTO Total Due All Columns: $