Assumption Catholic School PTO Name Email address

Phone # Teacher of Oldest Child

Clothing & Accessories % QTY Total Dining - On The Go % QTY Total American Eagle $25 10% $ Arby's $10 8% $ Banana Republic $25 14% $ $10 4% $ Children's Place $25 12% $ $10 10% $ Famous Footwear $25 8% $ $10 8% $ Jos. A Bank $25 10% $ $10 3% $ Gap $25 14% $ Domino's $10 8% $ Gap $100 14% $ Dunkin' Donuts $10 3% $ Gymboree $25 13% $ Fazoli's $25 7% $ L.L.Bean $25 16% $ $10 4% $ L.L.Bean $100 16% $ Little Caesar's Pizza $20 8% $ Lands' End $25 16% $ Potbelly Shop $10 8% $ Lands' End $100 16% $ Papa John's Pizza $10 8% $ Limited $25 9% $ Papa Murphy's Pizza $10 8% $ Old Navy$25 14% $ $10 8% $ Shoe Carnival $25 7% $ $25 7% $ Department Store % QTY Total St. Louis Bread Co $10 9% $ Dillard's $25 9% $ St. Louis Bread Co $25 9% $ jcpenney $25 5% $ $10 7% $ jcpenney $100 5% $ Starbucks $25 7% $ Kohl's $25* 4% $ $10 6% $ Kohl's $100* 4% $ Steak 'n Shake $10 8% $ Macy's $25 10% $ $10 5% $ Macy's $100 10% $ Wendy's $10 4% $ Sears $25 4% $ Discount Store % QTY Total Sears $100 4% $ Gordmans $25 7% $ Dining- Casual % QTY Total Target $25 2.5% $ Applebee's $25 8% $ Target $50 2.5% $ Bob Evans $10 10% $ Target $100 2.5% $ Buffalo Wild Wings $10 8% $ T.JMaxx/Marshalls/HomeGoods $25 7% $ Buffalo Wild Wings $25 8% $ T.JMaxx/Marshalls/HomeGoods $100 7% $ Cheesecake Factory $25 5% $ Walmart/Sam's Club $25 2.5% $ Chevy's Fresh Mex $25 8% $ Walmart/Sam's Club $100 2.5% $ Cracker Barrel $10 9% $ Home Improvement % QTY Total Cracker Barrel $25 9% $ Lowe's $25 4% $ Denny's $10 7% $ Lowe's $100 4% $ IHOP $25 8% $ Menards $25 3% $ Longhorn Steakhouse $25 9% $ Menards $100 3% $ O'Charley's $25 13% $ The Home Depot $25 4% $ $25 8% $ The Home Depot $100 4% $ P.F. Changs $25 8% $ Health & Beauty % QTY Total ® $25 9% $ CVS $25 6% $ $25 9% $ GNC $25 8% $ Ruby Tuesday $25 8% $ Sephora $20 5% $ Texas Roadhouse $25 8% $ Walgreens $25 6% $

Make Checks Payable To: Assumption PTO Electronics & Office % QTY Total Entertainment % QTY Total Best Buy® $25 3% $ AMC Theatres $10 8% $ Best Buy® $100 3% $ Dave & Buster's $25 13% $ Best Buy® $250 3% $ Regal Theatres $10 8% $ GameStop $25 3% $ Regal Theatres $25 8% $ Office Depot $25 5% $ Gas & Auto % QTY Total Office Max $25 5% $ Advanced Auto Parts $25 7% $ Service % QTY Total Autozone $25 8% $ Great Clips $25 8% $ BP $50 1.5% $ Regis Salons $25 8% $ Exxon/Mobil $50 1% $ Supercuts $25 8% $ Jiffy Lube $30 8% $ Specialty Retailer % QTY Total MotoMart $50 5% $ Barnes & Noble $25 9% $ Shell $25 2% $ Bath & Body Works $10 13% $ Shell $50 2% $ Bath & Body Works $25 13% $ Grocery % QTY Total Claire's $10 9% $ Dierbergs $25 2.5% $ Hallmark $25 4% $ Dierbergs $100 2.5% $ Jo-Ann Fabric and Craft Stores $25 6% $ Shop 'N Save $25 4% $ Michaels $25 4% $ Shop 'N Save $100 4% $ PetSmart $25 4% $ Home Decor % QTY Total Toys"R"Us/Babies "R" Us $20 3% $ Bed Bath & Beyond $25 7% $ Toys"R"Us/Babies "R" Us $100 3% $ Bed Bath & Beyond $100 7% $ Sporting Goods % QTY Total Pier 1 Imports $25 9% $ Bass Pro Shops $25 9% $ Pottery Barn $25 8% $ Cabela's $25 11% $ Pottery Barn $100 8% $ Cabela's $100 11% $ Online Stores % QTY Total Dick's Sporting Goods $25 8% $ Amazon.com $10 3% $ Dick's Sporting Goods $100 8% $ Amazon.com $25 3% $ Nike $25 12% $ Amazon.com $100 3% $ Travel % QTY Total Groupon.com $10 7% $ Avis Car Rental $50 8% $ iTunes $15 5% $ BedandBreakfast.com $50 10% $ iTunes $25 5% $ Big Cedar Lodge $25 9% $ Omaha Steaks $25 11% $ Big Cedar Lodge $100 9% $ Shutterfly $25 9% $ Budget Car Rental $50 8% $ Disney $25 2% $ Total Amount Due $______Disney $100 2% $ Check # ______

Make check out to Assumption. Place in an envelope marked Scrip and send it in to school office. * Gift cards may be used to pay on store credit card NO CASH balance

For current due date, visit the Assumption School website under the Activities tab.

Make Checks Payable To: Assumption PTO