St. Pius' Handy Cash Order Form Contact Name: Orders due by Street Address: Fri. Dec. 9th to guarantee City, State, Zip Code: delivery Oldest Student & Room: on/or before Mon. Dec. 19th. Blank Gift Certificates Purchased: Amount: $________ Qty: _________ Total: $__________ Gift certificate type : ___Happy Holidays ___Happy Birthday ___Thank You! ___Teacher Appreciation ___All Occasion Participating Merchants Retail Stores Quantity Total Retail Stores Cont'd Quantity Total A. C. Moore $25 K Mart $25 / $50 Ace Hardware $25 Kohl's $25 / $100 Advance Auto Parts $25 LL Bean $25 / $100 Amazon.com $25 / $100 Lands' End $25 / $100 American Eagle Outfitters $25 Limited $25 AutoZone $25 Lowe's $25 / 100 / 500 Babies R Us $20 / $100 Macy's $25 / $100 Banana Republic $25 / $100 Marshalls / TJ Maxx $25 / $100 Barnes & Noble Books $10 / 25 / 100 Men's Wearhouse $25 Bass Pro Shops $25 / $100 Michael's Arts & Crafts $25 Bath & Body Works $10 / $25 Office Depot/Office Max $25 / $100 Bed Bath & Beyond $25 / $100 Old Navy $25 / $100 BestBuy $25 / 100 / 250 Overstock.com $25 Buckle $25 Payless Shoes $20 Build-A-Bear Workshop $25 Peebles $25 Burlington Coat Factory $25 Pep Boys $20 Claire's $10 Pet Smart $25 Crate and Barrel $25 / $100 Pier I Imports $25 Crazy 8 $25 Pottery Barn $25 / $100 CVS Pharmacy $25 / $100 REI $25 Dick's Sporting Goods $25 / $100 Rite Aid $25 Dillard's $25 / $100 Ross Dress for Less $25 Disney $25 / 100 / 1000 Sally Beauty $25 Express $25 Sears $25 / 100 / 250 Express for Men $25 Sephora $20 Finish Line $25 Shoe Carnival $25 Footlocker Stores $25 Shutterfly.com $25 Gap/Gap Kids/Baby Gap $25 / $100 Staples $25 / $100 GNC $25 Stein Mart $25 Great Clips $25 T.J. Maxx / A.J.Wrghts $25 / $100 Gymboree $25 Talbot's $25 Harry & David $50 Target $25 / 50 / 100 Home Depot $25 / 100 / 500 The Children's Place $25 J. Crew $25 Toys R Us / Kids R Us $20 / $100 JCPenney $25 / $100 Walgreens $25 / $100 JoAnn Fabrics $25 Walmart / Sam's Club $25 / 100 / 250 Journey's $25 Williams-Sonoma $25 / $100 Zappos.com $25 / $100 OVER Restaurants Quantity Total Restaurants Cont'd Quantity Total Applebee's $25/ $50 TGI Friday's $25 Arby's $10 Yard House $25 Bonefish Grill $25/ $50 Wendy's $10 Boston Market $10 Buffalo Wild Wings $10 / $25 Gas/Automotive Quantity Total Burger King $10 BP Gas $50 California Pizza Kitchen $25 Jiffy Lube $30 Carrabba's Italian Grill $25/ $50 Mobile / Exxon $50 / $250 Cheesecake Factory $25 Shell $25 / 50 / 100 Chili's $25/ $50 Speedway $25 / $100 Chipotle Mexican Grill $10 WaWa $25 / $100 Chuck E. Cheese $10 Cold Stone Creamery $10 Grocery Stores Quantity Total Cracker Barrel $10 / $25 Farm Fresh $25 / $100 Daves & Buster $25 Food Lion $25 / $100 Denny's $10 Whole Foods Market $25 / $100 Domino's Pizza $10 Dunkin Donuts $10 / $25 Fazoli's $25 Entertainment Quantity Total Fuddruckers $25 AMC Theaters $25 Hardee's $10 Cinemark Theaters $25 Honey Baked Ham $25 EB Games / Game Stop $25 IHop $25 itunes $15 / $25 Krispy Kreme $10 Regal Entertainment $25 Little Caesar's $20 Spa Finder $25 Longhorn Steakhouse $25 United Artist Theater $25 Long John Silvers $10 Macaroni Grill $25/ $50 Noodles & Company $10 Olive Garden $25 Outback Steakhouse $25/ $50 Don't see what you are looking for? Check out Panera Bread $10 / $25 www.shopwithscript.com to see the full list of available Pappa John's $10 merchants. P F Chang's $25 List your choices below Pizza Hut $10 Pizzeria Uno $25 Qdoba $25 Red Lobster $25 Red Robin $25 Ruby Tuesday's $25 Ruth Chris Steakhouse $50 Starbucks $10 / $25 Steak 'n Shake $10 Subway $10 Total cards purchased: Taco Bell $10 Texas Roadhouse $25 Total amount of cards: $ For office use only Card ID Numbers: Date Received from Cust. Date Order Fulfilled Form of Payment: Gift Certificate # $ Gift Certificate Numbers: Cash $ Check # $ Total Amount Received $ .