Family Order Form Created: 11/18/2015 4:34:37 PM Mary Queen of the Holy Rosary PTO Who will bring home your cards? Please note student name and Homeroom, or add your phone number and we will call you.

Please return form back to the MQ school front office by Friday, Dec 4. Gift cards will be returned the following week.

Name Customer #

Check # Order Date

Product % QTY Total Product % QTY Total Product % QTY Total Ace Hardware $25.00 4% $ Carrabba's Italian Grill 8% $ GNC $25.00 8% $ $25.00 aerie $25.00 10% $ Gordmans $25.00 7% $ Casual Male XL $25.00 9% $ Aeropostale $25.00 10% $ Great Clips $25.00 8% $ Children's Place $25.00 12% $ Amazon.com $100.00 3% $ Great Harvest Bread 6% $ Chili's Grill & Bar $25.00 11% $ $10.00 Amazon.com $25.00 3% $ 10% $ Groupon.com $25.00 7% $ AMC Theatres $25.00 8% $ $10.00 Gymboree $25.00 13% $ Chuck E. Cheese 8% $ American Eagle 10% $ $10.00 Outfitters $25.00 Hallmark $25.00 4% $ Cinemark Theatres 4% $ American Girl $100.00 9% $ $25.00 HomeGoods $25.00 7% $ American Girl $25.00 9% $ Claire's $10.00 9% $ Honey Baked Ham 12% $ $25.00 Applebee's $25.00 8% $ Cold Stone Creamery 8% $ $10.00 IHOP $25.00 8% $ Applebee's $50.00 8% $ Cracker Barrel $25.00 9% $ iTunes® $15.00 5% $ Arby's $10.00 8% $ CVS/pharmacy $10.00 6% $ iTunes® $25.00 5% $ Avis Car Rental $50.00 8% $ CVS/pharmacy $25.00 6% $ J. Crew $25.00 13% $ Babies"R"Us $100.00 3% $ Dairy Queen $10.00 3% $ Jo-Ann Fabric and Craft 6% $ Stores $25.00 Babies"R"Us $20.00 3% $ Dick's Sporting Goods 8% $ $25.00 Kmart $25.00 4% $ Barnes & Noble $10.00 9% $ Dillard's $100.00 9% $ Kmart $50.00 4% $ Barnes & Noble $25.00 9% $ Dillard's $25.00 9% $ Kohl's $100.00 4% $ Bath & Body Works 13% $ $10.00 Disney $100.00 2% $ Kohl's $25.00 4% $ Bath & Body Works 13% $ Disney $1000.00 2% $ $25.00 L.L.Bean $100.00 16% $ Bed Bath & Beyond 7% $ Disney $25.00 2% $ L.L.Bean $25.00 16% $ $25.00 Donatos $10.00 10% $ Lands' End $100.00 16% $ Best Buy® $100.00 3% $ Dressbarn $25.00 8% $ Lands' End $25.00 16% $ Best Buy® $25.00 3% $ Dunkin' Donuts $10.00 3% $ Lands' End Kids $25.00 16% $ Bob Evans $10.00 10% $ Dunkin' Donuts $25.00 3% $ Lands' End School 16% $ Bonefish Grill $25.00 8% $ $25.00 EB Games $25.00 3% $ BP $50.00 1.5% $ Lane Bryant $25.00 8% $ Express $25.00 10% $ Bruster's Ice Cream 8% $ Limited $25.00 9% $ $10.00 Express for Men $25.00 10% $ Little Caesar's Pizza 8% $ Budget Car Rental 8% $ $20.00 $50.00 Fazoli's $25.00 7% $ Logan's Roadhouse 10% $ Buffalo Wild Wings 8% $ Finish Line $25.00 10% $ $25.00 $10.00 Foot Locker $25.00 9% $ LongHorn Steakhouse 9% $ Buffalo Wild Wings 8% $ ® $25.00 $25.00 GameStop $25.00 3% $ Lowe's $100.00 4% $ Build-A-Bear Workshop 8% $ Gap $25.00 14% $ $25.00 Lowe's $25.00 4% $ Burger King $10.00 4% $ GFS Marketplace 4% $ $100.00 Macaroni Grill $25.00 11% $ Cabela's $100.00 11% $ GFS Marketplace 4% $ Macy's $100.00 10% $ Cabela's $25.00 11% $ $25.00 Macy's $25.00 10% $

Make Checks Payable To: MQHR PTO Total Due All Columns: $ Family Order Form Created: 11/18/2015 4:34:37 PM Mary Queen of the Holy Rosary PTO Who will bring home your cards? Please note student name and Homeroom, or add your phone number and we will call you.

Please return form back to the MQ school front office by Friday, Dec 4. Gift cards will be returned the following week.

Name Customer #

Check # Order Date

Product % QTY Total Product % QTY Total Product % QTY Total Marathon $100.00 3% $ Pizzeria Uno $25.00 12% $ Texas Roadhouse 8% $ $25.00 Marathon $25.00 3% $ Pottery Barn $100.00 8% $ TGI Fridays $25.00 9% $ Marshalls $100.00 7% $ Pottery Barn $25.00 8% $ The Home Depot 4% $ Marshalls $25.00 7% $ Pottery Barn Kids 8% $ $100.00 $100.00 The Home Depot 4% $ Meijer (not AK and HI) 3% $ $25.00 $100.00 Pottery Barn Kids 8% $ $25.00 Tony Roma's $25.00 12% $ Meijer (not AK and HI) 3% $ $25.00 Qdoba Mexican Grill 7% $ $25.00 Toys"R"Us $20.00 3% $ Men's Wearhouse 8% $ $25.00 Red Lobster ® $25.00 9% $ ULTA $25.00 4% $ Michaels $25.00 4% $ $25.00 9% $ Under Armour $25.00 11% $

Motherhood Maternity 8% $ Ruby Tuesday $25.00 8% $ Walgreens $25.00 6% $ $25.00 Sam's Club $100.00 2.5% $ Walmart $100.00 2.5% $ Nike $25.00 12% $ Sam's Club $25.00 2.5% $ Walmart $25.00 2.5% $ Noodles & Company 8% $ $10.00 Sears $100.00 4% $ Wendy's $10.00 4% $ NOOK by Barnes & 9% $ Noble $10.00 Sears $25.00 4% $ White Barn Candle Co 13% $ $10.00 NOOK by Barnes & 9% $ See's Candies $25.00 9% $ Noble $25.00 Whole Foods Market 3% $ $100.00 O'Charley's $25.00 13% $ Sephora $20.00 5% $ Whole Foods Market 3% $ Office Max $100.00 5% $ Shell $100.00 2% $ $25.00 Shell $25.00 2% $ Williams-Sonoma 8% $ Office Max $25.00 5% $ $25.00 Old Chicago $25.00 6% $ Shoe Carnival $25.00 5% $

Old Navy $25.00 14% $ Shutterfly $25.00 9% $

Olive Garden ® $25.00 9% $ Smashburger $10 10% $ $10.00 Omaha Steaks $25.00 11% $ Speedway $25.00 4% $

Oriental Trading 9% $ Staples $100.00 5% $ Company $25.00 Outback Steakhouse 8% $ Staples $25.00 5% $ $25.00 Starbucks $10.00 7% $ Overstock.com $25.00 8% $ Starbucks $25.00 7% $ P.F. Chang's China 8% $ Bistro $25.00 Steak 'n Shake $10.00 8% $

Panera Bread $10.00 9% $ SUBWAY® Restaurants 6% $ $10.00 Panera Bread $25.00 9% $ SUBWAY® Restaurants 6% $ Papa John's Pizza 8% $ $50.00 $10.00 Sunglass Hut $25.00 12% $ Payless Shoes $20.00 13% $ Supercuts $25.00 8% $ PBteen $25.00 8% $ T.J. Maxx $25.00 7% $ PetSmart $25.00 4% $ Taco Bell $10.00 5% $ Pier 1 Imports $25.00 9% $ Talbots $25.00 13% $ (Not AK or HI) 8% $ $10.00 Target $25.00 2.5% $

Make Checks Payable To: MQHR PTO Total Due All Columns: $