Trip Certificate Order Form

TRIP CERTIFICATE ORDER FORM

NAME ______PHONE # ______DATE ______

Account #______School______PICK UP BY SELF _____ SEND HOME WITH STUDENT______PLEASE PLACE YOUR ORDER ONLINE AT: Grade/Teacher ______WWW.TRIPNORTHLLC.COM More merchant options available online!!! _____ Send Home With Parent ______

GROCERY & FOOD iHop 7.25% $ 25.00 x _____=______Acme ($100) 4.25% $ 25.00 x _____=______Little Caesars 7.25% $ 20.00 x _____=______ALDI($100) 1.00% $ 25.00 x _____=______Maggianos 10.25% $ 25.00 x _____=______Buehler's Foods($100) 4.25% $ 25.00 x _____=______*Malley’s Candy 19.00% $ 10.00 x _____=______Earthfare 4.50% $ 25.00 x _____=______Mangia Mangia 9.50% $ 20.00 x _____=______GIANT EAGLE ($50/$100/$500)4.25% $ 25.00 x _____=______Mavis Winkle's (Twins.) 9.50% $ 20.00 x _____=______Heinen’s ($50/$100/$500) 4.25% $ 25.00 x _____=______Max & Erma's 4.25% $ 25.00 x _____=______Marc's ($25/$100) 1.50% $ 10.00 x _____=______McDonald's($25) 4.00% $ 10.00 x _____=______Miles Farm Market 4.25% $ 25.00 x _____=______*Mr. Chicken 9.25% $ 5.00 x _____=______Mustard Seed 4.25% $ 25.00 x _____=______Mr. Hero 11.00% $ 5.00 x _____=______Pepper's Market 3.25% $ 25.00 x _____=______Mitchell's Fish ($100) 4.25% $ 25.00 x _____=______Gordon Foods ($100) 3.25% $ 25.00 x _____=______Morton's Steakhouse/Landrys 8.25% $ 25.00 x _____=______Whole Foods ($100) 2.25% $ 25.00 x _____=______O'Charleys 12.00% $ 25.00 x _____=______AUTOMOTIVE Olive Gard/Red Lobster/ 8.25% $ 25.00 x _____=______Advance Auto Parts 6.25% $ 25.00 x _____=______Bahama Breeze/Longhorn Steakhouse Auto Zone 7.25% $ 25.00 x _____=______Omaha Steaks 10.00% $ 25.00 x _____=______BP 2.00% $ 50.00 x _____=______Outback/Bonefish/Carrabas 7.25% $ 25.00 x _____=______Circle K 2.00% $ 50.00 x _____=______P.F. Chang's 7.25% $ 25.00 x _____=______Finish Line Car Wash (Solon)48.50% $ 25.00 x _____=______Panera's ($10/$25/$50) 9.25% $ 5.00 x _____=______PILOT/FLYING J($100) 1.50% $ 25.00 x _____=______Papa John's Pizza 7.25% $ 10.00 x _____=______Marathon ($100/$250) 2.25% $ 25.00 x _____=______*Penn Station 7.75% $ 10.00 x _____=______Sheetz Gas ($100) 2.25% $ 25.00 x _____=______Piada Itl. St. Food 3.75% $ 25.00 x _____=______Shell Gas ($50/$100) 2.00% $ 25.00 x _____=______Pizza Hut 7.25% $ 10.00 x _____=______Speedway ($50/$100/$250) 4.25% $ 25.00 x _____=______Pizzazz/Slice Pizzeria 8.75% $ 25.00 x _____=______RESTAURANTS Qdoba Mexican 6.25% $ 25.00 x _____=______Aladdins Eatery 3.75% $ 20.00 x _____=______Quaker Steak & Lube 4.25% $ 25.00 x _____=______Applebees 7.25% $ 25.00 x _____=______Red Robin Restaurant 8.25% $ 25.00 x _____=______Arby’s 7.25% $ 10.00 x _____=______*Rosati's Froz Cust(Nfld.) 14.50% $ 5.00 x _____=______Bob Evans($25) 4.50% $ 10.00 x _____=______Ruby Tuesday 7.25% $ 25.00 x _____=______Boston Market 11.00% $ 10.00 x _____=______Scrambler Marie's 4.25% $ 25.00 x _____=______Bravo/Brio 11.00% $ 25.00 x _____=______Starbucks ($25) 6.25% $ 10.00 x _____=______Bruegger's Bagels 6.25% $ 10.00 x _____=______Steak 'n Shake 7.25% $ 10.00 x _____=______Burger King($25) 4.25% $ 15.00 x _____=______Subway ($25/$50) 5.25% $ 10.00 x _____=______BW3 7.25% $ 25.00 x _____=______Sweet Frog(Stow/Fair/Green) 15.00% $ 10.00 x _____=______California Pizza Kitchen 7.25% $ 25.00 x _____=______T.G.I. Fridays 8.25% $ 25.00 x _____=______Casa D'Angelo(Macedonia) 13.50% $ 25.00 x _____=______Taco Bell 4.25% $ 10.00 x _____=______Cheesecake Factory 4.50% $ 25.00 x _____=______Teresa's Pizza 3.75% $ 20.00 x _____=______Chick-Fil-A 2.00% $ 10.00 x _____=______Texas de Brazil 3.25% $ 50.00 x _____=______Chili’s /Macaroni Grill/Maggiano10.25% $ 25.00 x _____=______Texas Roadhouse 9.25% $ 25.00 x _____=______Chipotle($25) 9.25% $ 10.00 x _____=______Tim Horton's 4.25% $ 10.00 x _____=______Chuck E. Cheese's 7.25% $ 10.00 x _____=______Wendy’s 3.25% $ 10.00 x _____=______Cold Stone Creamery 7.25% $ 10.00 x _____=______*Zeppe's Pizza 9.50% $ 10.00 x _____=______Cracker Barrel($25) 8.25% $ 10.00 x _____=______MERCHANTS crazybut true Popcorn 28.50% $ 10.00 x _____=______Ace Hardware ($100) 3.25% $ 25.00 x _____=______DAIRY QUEEN (NATIONAL) 2.25% $ 10.00 x _____=______Adidas 12.00% $ 25.00 x _____=______*Dairy Queen (Twinsburg) 8.75% $ 1.00 x _____=______Aeropostale 9.25% $ 25.00 x _____=______Dave & Buster's 12.25% $ 25.00 x _____=______Amazon($25/$50/$100) 4.25% $ 10.00 x _____=______Denny’s 6.25% $ 10.00 x _____=______American Eagle/aerie 9.25% $ 25.00 x _____=______DiBella's Subs 3.75% $25.00 x _____=______American Girl($100) 8.25% $ 25.00 x _____=______Domino’s Pizza 7.25% $ 10.00 x _____=______Athleta/Banana Republic 13.25% $ 25.00 x _____=______Donato's Pizza 9.25% $ 10.00 x _____=______Barnes&Noble($10) 8.25% $ 25.00 x _____=______Dunkin Donuts 2.25% $ 10.00 x _____=______Bass Pro Shops($100) 8.25% $ 25.00 x _____=______Eat 'n Park($25) 9.25% $ 10.00 x _____=______Bath & Body ($25) 12.25% $ 10.00 x _____=______Einstein Bagels 9.25% $ 10.00 x _____=______Bed Bath & Beyond($100) 6.25% $ 25.00 x _____=______Fannie May 24.00% $ 10.00 x _____=______Best Buy ($100/$250) 4.25% $ 25.00 x _____=______Farrinaci Pizza(Northfield) 4.75% $ 10.00 x _____=______Best Cuts/Regis 7.25% $ 25.00 x _____=______Firehouse Subs($25) 3.75% $15.00 x _____=______Brooks Brothers 15.25% $ 25.00 x _____=______First Watch 4.25% $ 25.00 x _____=______Build-A-Bear 7.25% $ 25.00 x _____=______Great Harvest Bread 5.25% $ 10.00 x _____=______Burlington Coat Factory 7.25% $ 25.00 x _____=______Honeybaked Ham($50) 14.00% $ 10.00 x _____=______Cabela’s ($100) 10.00% $ 25.00 x _____=______*Honey Hut 14.50% $ 5.00 x _____=______Carter's/Oshkosh($50) 9.00% $ 25.00 x _____=______MERCHANTS CONTINUED NetFlix($60) 4.25% $ 30.00 x _____=______Children's Place 11.00% $ 25.00 x _____=______Nike 11.00% $ 25.00 x _____=______Cinemark 3.25% $ 25.00 x _____=______Nordstrom's($50/$100) 4.25% $ 25.00 x _____=______Claire’s/Icing 8.25% $ 10.00 x _____=______Office Max($50) 4.25% $ 25.00 x _____=______Container Store($100) 8.25% $ 25.00 x _____=______Oriental Trading 8.25% $ 25.00 x _____=______Costco($100) 1.50% $ 25.00 x _____=______Overstocks.com 7.25% $ 25.00 x _____=______Crate and Barrel ($100) 7.25% $ 25.00 x _____=______P. Graham Dunn 24.00% $ 25.00 x _____=______Crazy 8 12.00% $ 25.00 x _____=______Pac Sun 4.25% $ 25.00 x _____=______CVS Pharm($25/$50) 5.75% $ 10.00 x _____=______Pat Catan's 9.25% $ 10.00 x _____=______Dick’s Sporting ($100) 7.25% $ 25.00 x _____=______Payless Shoes 12.00% $ 20.00 x _____=______Dillard’s ($100) 8.25% $ 25.00 x _____=______Petco 4.25% $ 25.00 x _____=______Disney ($15/$100 & $500) 4.25% $ 25.00 x _____=______PetSmart 4.25% $ 25.00 x _____=______Dress Barn 7.25% $ 25.00 x _____=______Pier One Imports 8.25% $ 25.00 x _____=______Drug Mart 2.25% $ 25.00 x _____=______QVC$100) 3.75% $ 25.00 x _____=______DSW Shoes 4.25% $ 25.00 x _____=______Regal Cinem./UA($25) 7.25% $ 10.00 x _____=______Dunham's Sports 7.25% $ 25.00 x _____=______*Regal Single Ticket 9.25% $ 9.25 x _____=______Elder-Beerman 7.25% $ 25.00 x _____=______Ritchie's Sports (Tallmadge) 9.00% $ 25.00 x _____=______Express/Structure 9.00% $ 25.00 x _____=______Rite Aid 3.25% $ 25.00 x _____=______Facebook 3.75% $ 15.00 x _____=______Saks Fifth Avenue$50) 3.75% $ 25.00 x _____=______Famous Footwear 7.25% $ 25.00 x _____=______Sally Beauty 11.00% $ 25.00 x _____=______Finish Line 9.25% $ 25.00 x _____=______*Schoolbelles 3.75% $ 25.00 x _____=______Foot Locker 8.25% $ 25.00 x _____=______Sears ($100) 4.25% $ 25.00 x _____=______Forever 21 ($50) 4.25% $ 25.00 x _____=______Sephora 4.25% $ 25.00 x _____=______Game Stop/EB Games 4.25% $ 25.00 x _____=______Shoe Carnival 4.25% $ 25.00 x _____=______Gap/Old Navy ($100) 13.00% $ 25.00 x _____=______*Shutterfly.com 8.25% $ 25.00 x _____=______GNC 7.25% $ 25.00 x _____=______Staples 4.25% $ 25.00 x _____=______Great Clips 7.25% $ 25.00 x _____=______Talbots 12.00% $ 25.00 x _____=______Groupon.com($25) 6.25% $ 10.00 x _____=______Target($100) 4.50% $ 25.00 x _____=______Guitar Center 3.25% $ 25.00 x _____=______T.J. Maxx/Home Gds($100) 6.25% $ 25.00 x _____=______Gymboree 12.00% $ 25.00 x _____=______Toys/Kids/BabyRUs($50) 4.25% $ 25.00 x _____=______Hallmark 3.25% $ 25.00 x _____=______Ulta Salons 3.25% $ 25.00 x _____=______Harley Davidson 4.25% $ 25.00 x _____=______Under Armour 10.00% $ 25.00 x _____=______Harry & David 9.25% $ 25.00 x _____=______Walgreen's ($100) 5.25% $ 25.00 x _____=______Hartville Hardware($100) 3.00% $ 25.00 x _____=______Wm. Sonoma/Ptry. Barn($100) 7.25% $ 25.00 x _____=______H&M ($50) 4.25% $ 25.00 x _____=______Walmart/Sam's($100/$250) 2.25% $ 25.00 x _____=______Hollister($50) 3.75% $ 25.00 x _____=______World Market 4.25% $ 25.00 x _____=______Home Depot ($100/$500) 4.25% $ 25.00 x _____=______Yankee Candle 3.75% $ 25.00 x _____=______iTunes($25) 4.75% $ 15.00 x _____=______Zappos.com 7.25% $ 25.00 x _____=______J. Crew 12.00% $ 25.00 x _____=______JC Penney ($50) 4.25% $ 25.00 x _____=______Joann's 5.25% $ 25.00 x _____=______GREAT EXTRAS/TRAVEL Journey's 9.25% $ 25.00 x _____=______1-800 Flowers 11.00% $ 50.00 x _____=______Justice/Limited 2 4.25% $ 25.00 x _____=______*Avis Rent A Car 7.25% $ 50.00 x _____=______*Kid's Kloset Uniforms (CF) 8.75% $ 25.00 x _____=______Best Western Hotels($100) 11.00% $ 25.00 x _____=______Kmart($50) 4.25% $ 25.00 x _____=______*Budget Car Rental 7.25% $ 50.00 x _____=______**Kohl’s ($25/$50/$100) 4.25% $ 10.00 x _____=______*Carnival Cruises 4.25% $100.00 x _____=______L L Bean ($100) 15.00% $ 25.00 x _____=______Choice Hotels($100) 2.25% $ 50.00 x _____=______Land’s End ($100) 15.00% $ 25.00 x _____=______Delta Airlines($1,000) 3.25% $ 250.00 x _____=______Lane Bryant 7.25% $ 25.00 x _____=______*Hyatt Hotels($100) 8.25% $ 50.00 x _____=______Limited 8.25% $ 25.00 x _____=______*Nina/michelle's (Twins.) 8.75% $ 25.00 x _____=______Lowe’s ($100 & $500) 4.25% $ 25.00 x _____=______*Oscar Giovanni (both locations)2.25% $ 25.00 x _____=______Macy's 9.00% $ 25.00 x _____=______Royal Carribean Cruise 8.25% $100.00 x _____=______Maurice's 6.25% $ 20.00 x _____=______Southwest Air($200/$500) 4.25% $100.00 x _____=______*Menards ($100) 2.25% $ 25.00 x _____=______Stub Hub 4.25% $ 50.00 x _____=______Mario's Spas & Hotels 4.25% $ 25.00 x _____=______Studio Wish Salon 8.75% $ 25.00 x _____=______Men's Wearhouse 7.25% $ 25.00 x _____=______Ticketmaster($50) 4.25% $ 25.00 x _____=______Michaels 4.25% $ 25.00 x _____=______Universal Orlando 4.25% $100.00 x _____=______

GRAND TOTAL ENTIRE ORDER: TOTAL $ AMOUNT: ______CHECKS ONLY PLEASE – PAYABLE TO TRIP CHECK #: ______Contact TRIP before placing any order over $10,000. NAME:______NOTES: ($AMT) indicates larger denominated cards available. Please circle ($AMT) desired & indicate quantity. Ex: ($100) x 2 = $200 **Kohl's gift cards purchased through TRIP can be used to pay Kohl's credit card balances. Certificates are not subject to return or replaced. All % subject to change without notice. Merchants in BOLD are new. Merchants in ITALICS are only accepted at indicated locations. Any order discrepancies must be reported within 24 hours. Questions regarding order pick-up or delivery contact your school. Go to YOUR SCHOOLS WEBSITE FOR SPECIFIC TRIP information. (11/2016)