Scrip Order Form Orders are due by Monday at 8am. Visit shopwithscrip.com for more retailers or to order from the convenience of your own home. Contact Karen Johnson for questions, 651-652-6100 or [email protected]. Earn tuition credit without costing you a dime!

Name Family Tuition Credit

Check # Order Date

Product % QTY Total Product % QTY Total Product % QTY Total 1-800-Baskets $50.00 12% $ Bubba Gump Shrimp 9% $ Denny's $10.00 7% $ Co. $25.00 1-800-Flowers $50.00 12% $ Dick's Sporting Goods 8% $ Buca di Beppo $25.00 8% $ $25.00 Ace Hardware $25.00 4% $ Buckle $25.00 8% $ Discover® Universal 1.25% $ Advance Auto Parts 7% $ Gift Card $50.00 $25.00 Budget Car Rental 8% $ $50.00 Disney $25.00 2% $ Albertsons $25.00 4% $ Buffalo Wild Wings 8% $ Domino's $10.00 8% $ .com $100.00 3% $ $10.00 Dressbarn $25.00 8% $ Buffalo Wild Wings 8% $ Amazon.com $25.00 3% $ $25.00 Dunkin' Donuts $10.00 3% $ AMC Theatres Single 10% $ Build-A-Bear Workshop 8% $ Ticket $10.00 $25.00 Dunn Bros. Coffee 8% $ $10.00 American Eagle 10% $ Burger King $10.00 4% $ Outfitters $25.00 Econo Lodge $50.00 4% $ Burlington Coat Factory 8% $ American Girl $25.00 9% $ $25.00 Einstein Bros. Bagels 10% $ $10.00 Applebee's $25.00 8% $ Cabela's $25.00 11% $ Exxon $50.00 1% $ Arby's $10.00 8% $ Caribou Coffee $10.00 6% $ Famous Footwear 8% $ Athleta $25.00 14% $ Carl's Jr. $10.00 5% $ $25.00 Food Lion $25.00 3% $ AutoZone $25.00 8% $ Chart House $25.00 9% $ Foot Locker $25.00 9% $ Avis Car Rental $50.00 8% $ Cheesecake Factory 5% $ $25.00 Fossil $50.00 12% $ Babies"R"Us $20.00 3% $ Children's Place $25.00 12% $ Fuddruckers $25.00 8% $ Bakers Square 13% $ Chipotle Mexican Grill 10% $ Restaurant & Bakery $10.00 Funcoland $25.00 3% $ $25.00 Chuck E. Cheese 8% $ GameStop $25.00 3% $ Banana Republic 14% $ $10.00 $25.00 Cinemark Theatres 4% $ Gander Mountain 8% $ Barnes & Noble $10.00 9% $ $25.00 $25.00 Barnes & Noble $25.00 9% $ Claire's $10.00 9% $ Gap $25.00 14% $

Bath & Body Works 13% $ Coffee Bean & Tea Leaf 9% $ Gap Factory $25.00 14% $ $10.00 $25.00 GNC $25.00 8% $ Bath & Body Works 13% $ Cold Stone Creamery 8% $ $25.00 $10.00 Golf Galaxy $50.00 4% $

Bed Bath & Beyond 7% $ Container Store $25.00 9% $ Goody's $25.00 8% $ $25.00 Cracker Barrel $25.00 9% $ ® $100.00 4% $ Gordmans $25.00 7% $ Crate and Barrel $25.00 8% $ Best Buy® $25.00 4% $ Grand Hyatt $100.00 10% $ Crew Cuts $25.00 13% $ Best Western 12% $ Great Clips $25.00 8% $ International $25.00 Cub Foods (Not OH) 4% $ Great Harvest Bread 6% $ Big Fish $25.00 9% $ $100.00 $10.00 CVS Pharmacy $25.00 6% $ Bloomingdale's $25.00 12% $ Groupon.com $25.00 7% $ Dairy Queen $10.00 3% $ BP $100.00 1.5% $ Gymboree $25.00 13% $ Darden® Restaurants 9% $ Hallmark $25.00 4% $ BP $50.00 1.5% $ $25.00 Brooks Brothers $25.00 16% $ Dave & Buster's $25.00 13% $ Hardee's $10.00 5% $

Bruegger's Bagels 7% $ Dell Computer $100.00 4% $ Harry & David $50.00 12% $ $10.00 Delta Air Lines $250.00 4% $ Herberger's $25.00 8% $

Make Checks Payable To: Holy Cross Catholic School Total Due All Columns: $ Name Family Tuition Credit

Check # Order Date

Product % QTY Total Product % QTY Total Product % QTY Total Hilton 9% $ Marcus Theatres $25.00 9% $ Sam's Club $25.00 2.5% $ /Bloomingto n $100.00 Marshalls $25.00 7% $ Sears $25.00 4% $

Holiday Stationstores 4% $ Menards $25.00 3% $ Sears Auto Service 4% $ $100.00 Center $25.00 Michaels $25.00 4% $ Holiday Stationstores 4% $ Shopko $25.00 3% $ $25.00 Mills Fleet Farm $25.00 3.5% $ HomeGoods $25.00 7% $ Smashburger $10.00 10% $ Mobil $50.00 1% $ Honey Baked Ham 12% $ Software Etc. $25.00 3% $ $25.00 Nike $25.00 12% $ Staples $25.00 5% $ Hotels.com $100.00 6% $ Noodles & Company 8% $ Star Theatres $25.00 8% $ Houlihan's $25.00 8% $ $10.00 Nordstrom $25.00 6% $ Starbucks $10.00 7% $ Hyatt Regency $100.00 10% $ Office Depot / Office 5% $ Stein Mart $25.00 7% $ Icing $10.00 9% $ Max $25.00 SUBWAY® Restaurants 6% $ IHOP $25.00 8% $ Old $25.00 6% $ $10.00 iTunes® $15.00 5% $ Old Navy $25.00 14% $ SuperAmerica $25.00 4% $

J. Crew $25.00 13% $ Olive Garden ® $25.00 9% $ SuperValu $100.00 4% $ jcpenney $25.00 5% $ Outback Steakhouse 8% $ SuperValu $25.00 4% $ $25.00 T.J. Maxx $25.00 7% $ Jiffy Lube $30.00 8% $ Panda Express $25.00 8% $ Taco Bell $10.00 5% $ Jo-Ann Fabric and Craft 6% $ Panera Bread $10.00 9% $ Stores $25.00 Target $100.00 2.5% $ Journeys $25.00 10% $ Panera Bread $25.00 9% $ Target $25.00 2.5% $ Journeys Kidz $25.00 10% $ Papa Murphy's Pizza 8% $ $10.00 Texas Roadhouse 8% $ Kohl's $25.00 4% $ Payless Shoes $20.00 13% $ $25.00 TGI Fridays $25.00 9% $ Kwik Trip $100.00 4% $ Pep Boys $20.00 4% $ Kwik Trip $25.00 4% $ The Home Depot 4% $ PetSmart $25.00 4% $ $25.00 L.L.Bean $25.00 16% $ Pier 1 Imports $25.00 9% $ Toys"R"Us $20.00 3% $

Lady Foot Locker 9% $ Pizza Hut (Not AK or HI) 8% $ Tucci Benucch $25.00 12% $ $25.00 $10.00 ULTA $25.00 4% $ Lands' End $100.00 16% $ Pizza Ranch $25.00 8% $ Under Armour $25.00 11% $ Lands' End $25.00 16% $ Pottery Barn $25.00 8% $ Limited $25.00 9% $ United Artist Theatres 8% $ Rainforest Cafe $25.00 9% $ $25.00 Little Caesar's Pizza 8% $ Red Lobster ® $25.00 9% $ Walgreens $25.00 6% $ $20.00 LongHorn Steakhouse 9% $ Red Robin $25.00 9% $ Walmart $100.00 2.5% $ ® $25.00 Regal Theatres $25.00 8% $ Walmart $25.00 2.5% $ Lowe's $20.00 4% $ Regis Salons $25.00 8% $ Wendy's $10.00 4% $ Lowe's $25.00 4% $ Ruby Tuesday $25.00 8% $ Whole Foods Market 3% $ Macaroni Grill $25.00 11% $ $25.00 Ruth's Chris Steak 10% $ Macy's $25.00 10% $ House $50.00 Zappos.com $25.00 8% $ Maggiano's Little Italy 11% $ Sally Beauty Supply 12% $ $25.00 $25.00 Marathon $25.00 3% $ Sam's Club $100.00 2.5% $

Make Checks Payable To: Holy Cross Catholic School Total Due All Columns: $