Incarnation PTO Scrip Program Cash and Checks accepted. All orders are PRE-PAY only. For a complete listing of cards available, visit: www.shopwithscrip.com. Any questions, email [email protected] Thank you for your order. Name Contact informations: phone or email

Order Date Payment Type

Product % QTY Total Product % QTY Total Aeropostale $25.00 9.74% $ Kohl's $25.00 3.74% $ Amazon.com $25.00 2.24% $ L.L.Bean $100.00 15.74% $ American Eagle Outfitters $25.00 9.74% $ L.L.Bean $25.00 15.74% $ Applebee's® $25.00 7.74% $ Lands' End $100.00 15.74% $ Babies"R"Us $20.00 2.74% $ Lands' End $25.00 15.74% $ Barnes & Noble $10.00 7.74% $ Lowe's $100.00 3.74% $ Barnes & Noble $25.00 7.74% $ Lowe's $25.00 3.74% $ Bath & Body Works $10.00 12.74% $ Macy's $25.00 9.74% $ Bath & Body Works $25.00 12.74% $ Meijer (not AK and HI) $25.00 2.74% $ Bed Bath & Beyond $25.00 6.74% $ Meijer (not AK and HI) $50.00 2.74% $ Best Buy® $25.00 3.74% $ Nike $25.00 11.74% $ Bob Evans Restaurants® $10.00 9.74% $ Nordstrom $25.00 5.74% $ Bonefish/Carrabas/Outback $25 7.74% $ Office Depot / Office Max $25.00 4.74% $ Bonefish/Carrabas/Outback $50 7.74% $ P.F. Chang's China Bistro $25.00 7.74% $ Bravo / Brio $25.00 11.74% $ $10.00 7.74% $ Buffalo Wild Wings $10.00 7.74% $ Panera Bread $25.00 7.74% $ Buffalo Wild Wings $25.00 7.74% $ Papa John's Pizza $10.00 7.74% $ $10.00 3.74% $ Pizzeria Uno $25.00 11.74% $ Cabela's $25.00 10.74% $ Potbelly Shop $10.00 7.74% $ Cheesecake Factory $25.00 4.74% $ Rave Cinemas $25.00 3.74% $ Chili's Grill & Bar $25.00 10.74% $ $25.00 7.74% $ $10.00 9.74% $ Regal Theatres $25.00 7.74% $ Cinemark Theatres $25.00 3.74% $ REI $25.00 7.74% $ Claire's $10.00 8.74% $ Restaurant.com $20.00 49.74% $ $10.00 7.74% $ Sephora $25.00 4.74% $ Cracker Barrel $10.00 7.74% $ Shell $25.00 1.74% $ Cracker Barrel $25.00 7.74% $ $10.00 9.74% $ CVS Pharmacy® $25.00 5.74% $ Speedway $25.00 3.74% $ Dave & Buster's $25.00 12.74% $ $10.00 6.74% $ Dick's Sporting Goods $25.00 7.74% $ Starbucks $25.00 6.74% $ Discover® Universal $100.00 0.99% $ Steak 'n Shake $10.00 7.74% $ Disney $25.00 2.74% $ ® Restaurants $10.00 5.74% $ Domino's $10.00 7.74% $ T.J. Maxx/Marshalls/HomeGoods $25 6.74% $ Dunkin' Donuts $10.00 2.74% $ $10.00 4.74% $ Dunkin' Donuts $25.00 2.74% $ Target $25.00 2.24% $ Elder-Beerman $25.00 7.74% $ Target $50.00 2.24% $ Express $25.00 9.74% $ The Home Depot $100.00 3.74% $ Gap/Old Navy/Athleta $100.00 13.24% $ The Home Depot $25.00 3.74% $ Gap/Old Navy/Athleta $25 13.24% $ $10.00 4.74% $ Home Depot $25.00 3.74% $ Under Armour® $25.00 10.74% $ iTunes® $15.00 4.74% $ Walgreens $25.00 4.74% $ iTunes® $25.00 4.74% $ Walmart $25.00 2.24% $ J. Crew $25.00 12.74% $ Wendy's $10.00 3.74% $ Jo-Ann Fabric and Craft $25.00 5.74% $ Whole Foods Market $25.00 2.74% $ Journeys $25.00 9.74% $ Zappos.com $25.00 7.74% $ Additional Vendors: see www.shopwithscrip.com for more options

Total Due: Make Checks Payable To: Incarnation PTO