Gift Card Order Form - Sand Lake Elementary Name Date

Address Phone

City, State, Zip Student & Teacher

Merchant Card % QTY Total Merchant Card % QTY Total Value Donated Value Donated

Ace Hardware $ 25.00 4% $ Kwik Trip $ 25.00 4% $ Ace Hardware $ 100.00 4% $ Kwik Trip $ 50.00 4% $ Advance Auto Parts $ 25.00 7% $ Kwik Trip $ 100.00 4% $ Advance Auto Parts $ 100.00 7% $ Lands' End $ 25.00 15% $ Aeropostale $ 25.00 10% $ Macy's $ 25.00 10% $ Amazon.com $ 10.00 2.25% $ Marcus Theatres $ 25.00 8% $ Amazon.com $ 25.00 2.25% $ Menards $ 25.00 3% $ Applebee's $ 25.00 8% $ Menards $ 100.00 3% $ Applebee's $ 50.00 8% $ Michaels $ 25.00 4% $ Arby's $ 10.00 8% $ Noodles & Company $ 10.00 8% $ Athleta $ 25.00 14% $ Old Navy $ 25.00 14% $ Barnes & Noble $ 5.00 8% $ Olive Garden $ 10.00 8% $ Barnes & Noble $ 10.00 8% $ Olive Garden $ 25.00 8% $ Barnes & Noble $ 25.00 8% $ Panera Bread $ 5.00 8% $ Bath & Body Works $ 10.00 12% $ Panera Bread $ 10.00 8% $ Bath & Body Works $ 25.00 12% $ Panera Bread $ 25.00 8% $ Bed Bath & Beyond $ 25.00 7% $ Papa Murphy's Pizza $ 10.00 8% $ Best Buy $ 25.00 4% $ PetSmart $ 25.00 5% $ Best Buy $ 100.00 4% $ Red Lobster $ 25.00 8% $ Buffalo Wild Wings® $ 10.00 8% $ Ross Dress for Less $ 25.00 8% $ Buffalo Wild Wings® $ 25.00 8% $ Shutterfly $ 25.00 9% $ Build-A-Bear Workshop $ 25.00 8% $ Starbucks $ 5.00 7% $ Burger King $ 10.00 4% $ Starbucks $ 10.00 7% $ Caribou Coffee $ 10.00 6% $ Starbucks $ 25.00 7% $ Carter's $ 25.00 10% $ Subway Restaurants $ 10.00 6% $ Children's Place $ 25.00 12% $ Subway Restaurants $ 50.00 6% $ Chuck E. Cheese's $ 10.00 8% $ T.J. Maxx $ 25.00 7% $ Cold Stone Creamery $ 10.00 11% $ Taco Bell $ 5.00 5% $ Dairy Queen $ 10.00 3% $ Taco Bell $ 10.00 5% $ Darden Restaurants $ 25.00 8% $ Taco Bell $ 25.00 5% $ Domino's $ 10.00 8% $ Target $ 10.00 2.5% $ Dunkin' Donuts $ 10.00 3% $ Target $ 25.00 2.5% $ Dunkin' Donuts $ 25.00 3% $ Target $ 50.00 2.5% $ Fazoli's $ 25.00 9% $ Texas Roadhouse $ 25.00 8% $ Festival Foods$ 25.00 3% $ The Home Depot $ 10.00 4% $ Festival Foods$ 50.00 3% $ The Home Depot $ 25.00 4% $ Festival Foods$ 100.00 3% $ ULTA $ 25.00 4% $ Gap $ 25.00 14% $ Walgreens $ 25.00 5% $ Great Harvest Bread $ 10.00 6% $ Walmart $ 10.00 2.5% $ Hallmark $ 25.00 4% $ Walmart $ 25.00 2.5% $ Home Depot $ 25.00 4% $ Walmart $ 50.00 2.5% $ Home Depot $ 100.00 4% $ Walmart $ 100.00 2.5% $ iTunes $ 15.00 5% $ Wendy's $ 10.00 6.5% $ iTunes $ 25.00 5% $ JCPenney $ 25.00 5% $ Total # of cards & Kohl's $ 25.00 4% $ Total Amount

Simply return this sheet and payment to school with your student and you will be contacted when the order is ready. Checks should be made payable to Sand Lake PTG . Please allow 5-10 business days for order processing. ALL ORDERS OVER $300 PAID BY CHECK WILL BE HELD FOR 5-7 DAYS FOR CHECK TO CLEAR THE BANK.