SCRIP Card Order Form Make Checks out to: OAKFIELD SCRIP Your Family earns with every gift card purchased.

Customer Information Profit Directed Towards: Name Student Family Name Email Oakfield Elementary ______Oakfield JR/SR High Phone OSD Club or Staff name

To order: Fill out this form and return to the school Office. This list is the most commonly ordered items. Visit shopwithscrip.com for access to over 750+ local and national companies that are available for ordering. Denomination Quantity Total Cost Denomination Quantity Total Cost Ala Roma 10% $10 Pick-n-Save 4% $25 $25 $50

Applebee’s 8% $25 $100 Arby’s 8% $10 Piggly Wiggly 3% $25 Backyard Grill 5% $25 $50 Bagelmeister 10% $ 5 $100

Bath & Body Works 13% $10 8% $10

$25 7% $10

BP Rolling Meadows 5% $25 Rocky Rocco 10% $5 BP All Locations 2% $50 Staples 5% $25

Buffalo Wild Wings 8% $25 7% $10

Burger King 4% $25 $25

Cousins Subs 9% $10 6% $10

Culvers 8% $25 5% $10 Dunkin Donuts 2.5% $10 Target 2% $25 Eaton’s Pizza 10% $25 Tucker’s 5% $10 Festival Foods 3% $50 Walgreens 6% $25 $100 Walmart/Sam’s Club 2.5% $25

Fleet Farm 5% $25 $100 $50

See list on back of sheet or Visit ShopWithScrip.com to see $100 all 750+ brands and available denominations. Then, add to your order below. Friar Tuck’s/ Sebastian’s $10 5% Enter brand name Denomination Quantity Total Cost $25 $ Gilles 10% $5 $ Gino’s 7% $10 $ Jet Stream 10% $10 $ Kohls (CAN pay bill) 5% $25 $ $50 $ $100 $ Kwik Trip 4% $25 $ $100 $ Mancino’s 7% $5 $ McDonald’s 5% $10 $ Menards 3% $25 $ Mobil Drivers Card 2% $50 $ Noodles and Comp 8% $10 # Total $ Total

Panera Bread 9% $10 Papa Johns 8% $10 More info and companies on the back

Popular Denominations NAME OF COMPANY % PROFIT (other amounts avail for most) Advanced Auto Parts 7% $25.00 Amazon ($10, $25, $100) 3% American Eagle (debit) 10% $25.00 Barnes & Noble Bookstore (debit) ($20 & $25 avail) 9% $10.00 Best Buy (debit) ($100 & $250 avail) 3% $25.00 Best Western Int'l (debit) ($100 avail) 12% $25.00 Buckle (debit) 8% $25.00 Build-A-Bear 8% $25.00 Cabela's ($100 avail) 11% $25.00 Chili's (debit) 9% $25.00 Chuck E. Cheese 8% $10.00 Claire's (debit) 9% $10.00 (debit) 8% $10.00 Dick's Sporting Goods (debit) ($100 avail) 8% $25.00 Disney (debit) ($15, $25, $100 & $1,000 avail) 2% Domino's Pizza (debit) 8% $10.00 Dunham's Sports (debit) 8% $25.00 Eddie Bauer (debit) 10% $25.00 Fazoli's (debit) 7% $25.00 Game Stop/EB Games (debit) 3% $25.00 Gander Mountain (debit) 8% $25.00 Gap/Old Navy/Banana Republic (debit) 9% $25.00 Hardees (debit) 5% $10.00 Itunes (debit) ($25 avail) 5% $15.00 JCPenneys (debit) (cannot pay bill) ($100 avail) 5% $25.00 Jo Ann Fabrics (debit) 6% $25.00 Pizza (debit) 8% $20.00 Marriott Hotels (debit)(Fairfield Inns/Courtyard)($100 avail) 8% $50.00 Maurices (Closet) (debit) (cannot pay bill) 7% $20.00 Nike (Outlets) (debit) 12% $25.00 Nordstrom's (debit) (available in $20-$1000 increments) 6% $10.00 Office Max (debit) 5% $25.00 Old Country Buffet 5% $25.00 Olive Garden//Longhorn Steakhouse (debit) 9% $25.00 Payless Shoes (debit) 13% $20.00 Pier 1 Imports (debit) 9% $25.00 (debit) 9% $25.00 (debit) 9% $25.00 Sally Beauty Company (debit) 12% $25.00 Super America (Speedway) (debit) ($100 avail) 4% $25.00 T.J. Maxx (Marshalls) (debit) 7% $25.00 TGI Friday's (debit) 9% $25.00 Under Armour (debit) 11% $25.00 Wendys (debit) 4% $10.00 ENTER THESE ON FRONT OF SHEET WITH QUANITITY AND DENOMINATION

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Any questions?? Email us at [email protected]

Additional order forms, redemption forms and instructions available at www.oakfield.k12.wi.us/Scrip. THANK YOU FOR PARTICIPATING IN OUR PROGRAM!!!