All Saints Catholic School Scrip Order Form (208) 743-4411 - office (208) 743-9563 - fax

Name: Phone: Date: Send home with: Grade: Leave at Front Desk for Friday pick-up:

Vendor Amount Credit Qty Cost Vendor Amount Credit Qty Cost A & B Foods ** $5 5% K-Mart $25 4% A & B Foods ** $10 5% K-Mart $50 4% A & B Foods ** $20 5% Kohl's $25 4% Ace Hardware $25 4% Kohl's $100 4% Aeropostale $25 7% Albertsons $25 4% Albertsons $100 4% Amazon.com $25 4% Amazon.com $100 4% Land's End $25 16% American Eagle Outfitters $25 10% Lowe's $25 4% American Girl $25 & $100 9% Lowe's $100 4% Applebees $25 8% Auto Zone $25 9% Macy's ** $25 10% Macy's ** $100 10% Banana Republic $25 16% McDonald's $10/25/50 10% Barnes & Noble $10 9% Barnes & Noble $25&$100 $___ 9%

Bath & Body Works $10 13% Old Navy $25 9% Bath & Body Works $25 13% Olive Garden $25 9% Bed Bath and Beyond $25 7% Orchards Shoe Shop ** $____ 10% Best Buy $25 3% Outback Steakhouse $25 8% Big 5 Sporting Goods $25 8% Owl Pharmacy ** $10 10% Black Sheep $10 10% Black Sheep $20 10% Buckle $25 8% Payless Shoes ** $20 13% Build-A-Bear Workshop $25 8% Pier 1 Imports $25 9% $10 4% Pizza Hut $10 8% Cabela's $25 11% Polar Bear $____ 6% Chevron $100 1.5% Chevron $50 1.5% Chili's $25 11% Chuck E. Cheese $10 8% Radio Shack ** $25 4% Claire's $10 9% Red Lobster $25 9% Crate and Barrel $25 8% Red Robin $25 9% Restoration Hardware $25 12% Rite Aid $25 4% Dairy Queen $10 3% Rooster's Landing $____ 10% Diamond Shop ($25 min.)** $____ 7% Rosauer's $25 5% Disney $25 2% Rosauer's $100 5% Domino's Pizza $10 10% Rosauers $_____ 5% Ross Dress for Less $25 8% Eddie Bauer $25 10% Safeway $25 4% El Sombrero Restaurant ** $____ 8% Safeway $100 4% Exxon $50 1.5% ** $25 4% Footlocker (Lady & Kids) $25 9% Shell $25 2.5% Shell $100 2.5% Gap (Kids & Baby) $25 9% Shopko $25 3% GNC $25 8% Shopko $50 3% $25 13% Spot on Yogurt $10 8% Happy Day Restaurants ** $10 8% Sports Authority $25 8% Happy Day Restaurants ** $25 8% Staples $25 5% Happy Day Restaurants ** $____ 8% Starbuck's ** $10 7% Home Depot ** $25 4% Starbuck's ** $25 7% Home Depot ** $100 4% Subway $10 3% Target $25 2% iTunes $15 5% Target $100 2% iTunes $25 5% Texaco $50 2% Texaco $100 2% Jack in the Box $10 4% The Children's Place ** $25 12% JC Penney $25 5% Walgreen's $25 6% JC Penney $100 5% Walmart $25 *2.5% JoAnn Fabrics $25 6% Walmart $100 *2.5% Wendy's $10 4% Williams Sonoma $25 8% Village Centre Cinemas ** $9.00 $1/tkt Important information is on the back of this sheet.

TOTAL ORDER: TOTAL ORDER: Check #______

Debit / Credit Card Information - Visa / Mastercard / Discover Account # : ______Expiration Date : ______Name on Card : ______Street Address : ______Signature : ______

Check out www.glscrip.com for other vendors.

Should you find scrip on the web site that you wish to purchase, that is not listed on the front side of this form, please write that information in and we will order it for you.

PLEASE REVIEW RESTRICTIONS FOR NATIONAL VENDORS AT www.glscrip.com.

** RESTRICTIONS:

A&B Foods: Max cash back 99 cents Diamond Shop: $25 minimum. No exclusions. El Sombrero Restaurant: Any amount. Must be used in full. Happy Day Corporation: A & W, Arby's, Main Street Grill, Taco Time, Tomato Bros, Zany's (Quad City locations) Home Depot: Cannot be used for payment on account. Macy's: Cannot be used for payment on account. Orchards Shoes: Not good for men's work boots. Owl Pharmacy: Gifts only. Must be used in full. Payless Shoe Source: Change will be in the form of a merchandise certificate. Radio Shack: Cannot be used for payment on account. Sears: Cannot be used for payment on account. Starbucks: Cannot be used at airport or in grocery store The Children's Place: Cannot be used for payment on account. Village Centre Cinemas: Adult (13 & older) full price ticket. No cash back.

Jan. 12 Store Name Face Value Discount Store Name Face Value Discount 1-800-Flowers $25 10% Crate and Barrel $25/$100 8% Ace Hardware $25 4% CVS Pharmacy $25 6% Amazon.com $25 4% Del Taco $10 4% AMC Theatres $25 7% Denny's $10 7% American Airlines $100/$250 8% Dick's Sporting Goods $25 5% American Eagle Outfitters $25 9% Dillard's $25/$100 9% Arco Gas $50 2% Disney Gift Card $25/$100 2% AT&T 125 Min. Card $9.50 20% Dressbarn $25 8% Babies-R-Us $20 1.50% Dunkin Donuts $10 4% Baja Fresh $25 7% Edwards Theater $25 8% Banana Republic $25 9% El Pollo Loco $10 6% Barnes & Noble $10/$25 9% Express $25 13% Bass Pro Shop $25 9% Exxon $50/$2501.5 & 2% Bed Bath & Beyond $25 7% Fairfield Inn $50/$100 12% Best Buy $25/$100 2% Family Christian Stores $25 9% Best Western $25/$100 12% Footaction USA $25 9% Black Angus $20 14% Foot Locker $25 9% Blockbuster Gift Card $10 7% Gap $25 9% Bloomingdale's $25/$100 12% Bonefish Grill $25 5% Great Harvest Bread Co. $10 8% Borders $10/$25 9% Gymboree $25 13% Boston Market $10 12% HairMasters $25 8% BP Gas $50 2% Hard Rock Café $25 10% Brooks Brothers $25 16% Harry & David $25 10% $25 12% Hickory Farms $10 15% Buca Di Beppo $25 8% Honey Baked Ham $10 12% Budget Car Rental $50 8% Hyatt Hotels $25/$100 9% Build-A-Bear Workshop $25 8% iTunes $15 4% Cabela's $25 11% J.Crew $25 13% California Pizza Kitchen $10 4% Jamba Juice $10 7% Carl's Jr. $10 9% KB Toys $20 4% Carnival Cruises $100 8% Kits Camera $25 6% Carrows Restaurants $10 8% Kohl's $25/$100 4% Champs Sports Store $25 9% L.L. Bean $25/$100 15% Chart House $25 9% Lands' End $25/$100 17% Cheeseburger in Paradise $25 5% Chevy's Fresh Mex $25 8% Limited $25 9% Chili's $25 11% Linens 'n Things $25 8% Chipotle Mexican Grill $10 10% Loews Cineplex $25 7% Chop House & Brewery $25 6% Longs Drug Stores $25/$100 5% Chuck E. Cheese $10 8% Lord & Taylor $25 8% Cinemark Theatres $25 4% Lowe's $25/$100 4% Cineplex Odeon $25 7% Macaroni Grill $25 11% Circuit City $25/$100 3% Maggiano's Little Italy $25 11% Comfort Inn $25/$100 6% Marie Callendar's $25 18% Country Buffet $25 5% Marriott Hotels $50/$100 12% Cracker Barrel $10 9% Marshalls $25/$100 7% Store Name Face Value Discount Men's Wearhouse $25 8% Mrs. Field's Cookies $5 50%

Old Navy $25 9% Office Depot $25 4% Office Max $25 5% Olive Garden $25 9% Orvis $25 17% Outback Steakhouse $25 5%

Panera Bread $10 9% Pavillons $25/$100 4% Peet's Coffee & Tea $20 8% Pottery Barn $25/$100 8% Qdoba $25 7% Radio Shack $25 4% Randalls $25/$100 4% Red Robin $10 9% Regal Entertainment $25 8% Regis Salons $25 8% Restoration Hardware $25 12% Ritz-Carlton Hotel Co. $50 12% Ruby Tuesday's $25 8% Sam Goody $25 6% Scrip Wallet $1 15% See's Candies $15 $15.00 25% Shutterfly $25 9%

Sunglass Hut $25 12% Talbots $25 11% TCBY $5 10% Tesoro $25 2% TGI Friday's $25 9% The Children's Place $25 12%

Toys-R-Us $20 1.50% United Artist Theater $25 8%

West Elm $25/$100 8% White Barn Candle Co. $10/$25 13% Williams-Sonoma $25/$100 8% Wolf Camera $25 6%