St. John SCRIP Order Form Name: Sale/Order Date: Phone # Total Sale: Grade of Youngest Child: Cash ‐or‐ Check # Leave in Scrip Box ‐or‐ Send Home with Child Date Order Filled:
National Retailer Amount Qty National Retailer Amount Qty Aeropostale 7% $25 I‐Tunes 5% $15 Amazon.com 4% $25 I‐Tunes 5% $25 Amazon.com 4% $100 Jo Ann Fabrics 6% $25 American Eagle Outfitters 9% $25 J C Penney 5% $25 Barnes & Noble Bookstores 9% $10 J C Penney 5% $100 Barnes & Noble Bookstores 9% $25 K‐Mart 4% $25 Bath & Body Works 13% $10 K‐Mart 4% $50 Bed, Bath, and Beyond 7% $25 Kohl's 4% $25 Best Buy 3% $25 Kohl's 4% $100 Best Buy 3% $100 Limited 9% $25 Buckle 8% $25 Lowe's 4% $25 Cabela's 12% $25 Lowe's 4% $100 Children's Place 12% $25 Maurices 7% $20 ClaIr's Boutique / Icing 9% $10 Menards Home Centers 3% $25 Crazy 8 13% $25 Menards Home Centers 3% $100 CVS Pharmacy 6% $25 PetSmart 4% $25 Dick's Sporting Goods 8% $25 Sears 4% $25 Dick's Sporting Goods 8% $100 Sears 4% $100 Dillards 9% $25 Staples 5% $25 Fareway 3% $25 Target 3% $25 Fareway 3% $50 Target 3% $100 Fareway 3% $100 TJ Maxx 7% $25 Gap / Old Navy 9% $25 Walgreens 6% $25 Gordman's 7% $25 Wal‐Mart / Sam's Club 2.5% $25 Gymboree 13% $25 Wal‐Mart / Sam's Club 2.5% $100 Hallmark 4% $25 Wal‐Mart / Sam's Club 2.5% $250 Home Depot 4% $25 Younkers 8% $25 Home Depot 4% $100 Younkers 8% $100 Restaurants Amount Qty Restaurants Amount Qty Applebees 8% $25 Outback Steakhouse 5% $25 BBQ This! (Any Amount Available) 10% $10 Panera Bread 9% $10 Burger King 4% $10 Pizza Hut 8% $10 Cold Stone Creamery 8% $10 Starbucks 7% $10 Kentucky Fried Chicken 8% $5 Subway 3% $10 Old Chicago 6% $25 Taco Bell 5% $10 Olive Garden / Red Lobster Texas Roadhouse 8% $25 / Longhorn Steakhouse 9% $25 Wendy's 4% $10
Oil Changes / Gas Stations Amount Qty Dunlap Oil Change Coupon 20% $24.95 Casey's 3% $25 Music Station 4% $10 Casey's 3% $50 Kwik Star 9% $25 Kwik Star 9% $50 Bold type indicates commonly stocked cards Kwik Star 9% $100 For a complete Retailer List go to:
www.glscrip.com