Good Shepherd United Methodist In Partnership with www.unitedscrip.com Family Name Payment: Check: Cash: Phone Make Check Payable to: Good Shepherd United Methodist Church Date: UnitedScrip Certificate Form by Category June 2020 Certificate Qty Total Certificate Qty Total National Restaurants Applebee's $25 @ 8% IHOP $25 @ 8% Arby's $10 @ 8% Krispy Kreme $10, $25 or $50@ 10% Bob Evans $20 @ 10% Little Caesars $20 @ 8% Bonefish Grill $25 or $50 @ 8% LongHorn Steakhouse $10, $25 or $50 @ 8% Bruster's Ice Cream $5 @ 8% Maggiano's Little Italy $25 @ 10% Buffalo Wild Wings $25 @ 8% O'Charley's $25 @ 13% Burger King $10 @ 4% Olive Garden $10 $25 or $50 @ 5% California Pizza Kitchen $25.00 @ 6% Outback Steakhouse $25 or $50 @ 8% Carrabba's Italian Grill $25 or $50 @ 8% Panera Bread $10 & $25 @ 8% Cheesecake Factory $25.00 @ 5% Papa John's $10, $50 or $100 @ 8% Chili's $10, $25 or $50 @ 10% Pizza Hut $10 or $100 @ 8% Chipotle $10 or $25 @ 11% Pizzaria Uno $25 @ 12.5% Chuck E. Cheese's $10 @ 8% Red Lobster $25 or $50 @ 9% Cracker Barrel Old Country Store $10 or $25 @ 8% Red Robin $25 @ 8% Dairy Queen $10 @ 3% Ruby Tuesday $25 @ 6% Dave & Buster's $25 @ 13% Ruth’s Chris Steak House $50 @ 8% Domino's $10 or $50 @ 8% Starbucks $5, $10 or $25 @ 7% Dunkin Donuts $10 or $50 @ 3% Subway $10, $25 or $100 @ 3% Fleming's $25 or $50 @ 8% Taco Bell $10 @ 4% Golden Corral $25 @ 8% Texas Roadhouse $10 & $25 @ 8% Hardee's $10 @ 5% Wendy's $10 @ 4% HoneyBaked Ham $25 @ 13% National Retailers Advance Auto Parts $25 or $500 @ 7% Lands' End $25 or $100 @ 14% Amazon.com $10, $25, or $50 @ 3% L.L. Bean $25 or $100 @ 13% Amazon.com $100 or $250 @ 3% Loews Cineplex Entertainment $25 @ 7% AMC Single Use Ticket $12 @ 10% Lowe's Home Improvement $25, $50, or $100 @ 4% AMC Theatres/Loew's $25 @ 7% Lowe's Home Improvement $500 or $1000 @ 4% American Eagle Outfitters $25 @ 8% Macy's $25 & $100 @ 10% American Express $50, $100, or $250 @ 1% Marshall's $25 @ 7% American Girl $25 @ 9% Michaels $25 @ 4% AutoZone $25 @ 8% Mobil $50 or $100 @ 1% Avis Rental Car $50.00 @ 10% Office Depot/Office Max $25 @ 4% Banana Republic $25 @ 14% Old Navy $25 @ 14% Barnes & Noble Bookstores $25 @ 8% Petco $25 @ 5% Bass Pro Shops $25 or $100 @ 8% PetSmart $25 @ 5% Bath & Body Works $10 or $25 @ 13% Pinkberry $10 or $25 @ 8% Bed Bath & Beyond $25 or $100 @ 6% Pottery Barn $25 @ 8% Best Buy $25 or $100 @ 2% Regal Entertainment $10 or $25 @ 8% Bloomingdales $50 @ 7% REI Stores $25 @ 8% BP Gas Stations $50 or $100 @ 1.5% Rite Aid $25 or $100 @ 4% Build-A-Bear Workshop $25 @ 10% ROSS Dress For Less $25 @ 9% Burlington Coat Factory $25 @ 8% Sam's Club $25 or $100 @ 1.5% Cabela's $25 or $50 @ 9% Sephora $25 @ 5% Chevron Gas $50, $100, or $250 @ 1% Sheetz Gasoline $50 @ 3% Christmas Tree Shop $25 or $100 @ 6% Shell Gas $25, $50 or $100 @ 1.5% CVS $25 or $100 @ 4% Shoe Carnival $25 @ 4% Dick's Sporting Goods $25.00 @ 5% Shutterfly $25 @ 9% Disneyland/Disneyworld $25 or $100 @ 3% Staples $25 or $100 @ 5% Disneyland/Disneyworld $500 or $1000 @ 3% Sunglass Hut $25 @ 9% Disney Stores $25, $100, $500, $1000 @ 3% Sunoco $50, $100 or $250 @ 1% Exxon $50 or $100 @ 1% T.J. Maxx $25 or $100 @ 7% Fandango.com $25 @ 6% Talbots $25 @ 9% Food Lion $25.00 or $100 @ 3% Target $5, $10, $25 or $50 @ 2.5% Gamestop $25 @ 3% Target $100 or $250 @ 2.5% Gap $25 or$100 @ 14% Ulta Cosmetics and Salons $25 or $50 @ 4% Groupon $25 @ 7% United Artist Theater $10 or $25 @ 8% Hallmark $25 @ 4% Visa $50 or $100 @ 1.3% Home Depot $25, $50 or $100 @ 4% Walgreens $25 or $100 @ 5% Home Depot $500 or $1000 @ 4% Walmart $10, $25, $50 or $100 @ 1.5% HomeGoods $25 @ 7% Walmart $250 or $500 @ 1.5% iTunes $25 @ 5% Whole Foods $25.00 or $100 @ 3% Jo-Ann Stores $25 @ 6% Williams-Sonoma $25 or $100 @ 8% Kohl's $25 or $100 @ 4% World Market $25 or $100 @ 6% Grand Total: $ Comments/Notes/Special Instructions: We can not be responsible for lost or stolen Gift Cards. Please sign below in the appropriate box to indicate your preference for delivery. X X .