Family Order Form Created: 9/20/2016 3:28:51 PM Highlands Ranch Community Association Name Customer # Check # Order Date Product % QTY Total Product % QTY Total Product % QTY Total 76 Gas $25.00 1.5% $ Burger King $10.00 4% $ Dick's Sporting Goods 8% $ $25.00 99 Restaurants $25.00 13% $ Burlington Coat Factory 8% $ $25.00 Dillard's $25.00 9% $ Ace Hardware $25.00 4% $ Cabela's $25.00 11% $ Disney $25.00 2% $ Amazon.com $100.00 3% $ California Pizza Kitchen 8% $ Domino's $10.00 8% $ Amazon.com $25.00 3% $ $25.00 Downtown Aquarium 9% $ Caribou Coffee $10.00 6% $ AMC Theatres Single 10% $ $25.00 Ticket $10.00 Carl's Jr. $10.00 5% $ Dressbarn $25.00 8% $ AMC Theatres® $25.00 8% $ Carrabba's Italian Grill 8% $ Einstein Bros. Bagels 10% $ American Eagle 10% $ $25.00 $10.00 Outfitters $25.00 Carter's $25.00 10% $ Famous Footwear 8% $ American Girl $25.00 9% $ $25.00 Cheesecake Factory 5% $ Fazoli's $25.00 7% $ Applebee's $25.00 8% $ $25.00 Children's Place $25.00 12% $ Fleming's Prime 8% $ Aquarium $25.00 9% $ Steakhouse $25.00 Chili's Grill & Bar $25.00 11% $ Arby's $10.00 8% $ Foot Locker $25.00 9% $ Chipotle Mexican Grill 10% $ Athleta $25.00 14% $ $10.00 GameStop $25.00 3% $ Babies"R"Us $20.00 3% $ Choice Hotels $50.00 4% $ Gap $25.00 14% $ Baby Depot at 8% $ Chop House Brewery 6% $ Gap Factory $25.00 14% $ Burlington Coat Factory $25.00 GNC $25.00 8% $ $25.00 Chuck E. Cheese 8% $ Baja Fresh $25.00 7% $ $10.00 Gordmans $25.00 7% $ Cinemark Theatres 4% $ Banana Republic 14% $ $25.00 Great Clips $25.00 8% $ $25.00 Cinemark Theatres 10% $ Groupon.com $25.00 7% $ Barnes & Noble $10.00 9% $ Single Admit $9.50 Barnes & Noble $25.00 9% $ Circle K $25.00 1.5% $ Gymboree $25.00 13% $ Bass Pro Shops $25.00 9% $ Claire's $10.00 9% $ Hallmark $25.00 4% $ Bath & Body Works 13% $ Cold Stone Creamery 8% $ HomeGoods $25.00 7% $ $10.00 $10.00 Honey Baked Ham 12% $ Bath & Body Works 13% $ Columbia Sportswear 12% $ $25.00 $25.00 $50.00 IHOP $25.00 8% $ Bed Bath & Beyond 7% $ Comfort Suites $50.00 4% $ $25.00 iTunes® $15.00 5% $ Container Store $25.00 9% $ Best Buy® $25.00 4% $ iTunes® $25.00 5% $ Cool Cuts 4 Kids $25.00 8% $ Big 5 Sporting Goods 8% $ J. Crew $25.00 13% $ $25.00 Cracker Barrel $10.00 9% $ Bonefish Grill $25.00 8% $ Jack in the Box $10.00 4% $ Cracker Barrel $25.00 9% $ Boston Market $10.00 12% $ jcpenney $25.00 5% $ Crate and Barrel $25.00 8% $ Bubba Gump Shrimp 9% $ Jiffy Lube $30.00 8% $ Co. $25.00 Crazy 8 $25.00 13% $ Jo-Ann Fabric and Craft 6% $ Buckle $25.00 8% $ Dairy Queen $10.00 3% $ Stores $25.00 Buffalo Wild Wings 8% $ Dave & Buster's $25.00 13% $ Kohl's $25.00 4% $ $10.00 Del Taco $10.00 7% $ Krispy Kreme 8% $ Buffalo Wild Wings 8% $ Doughnuts® $10.00 $25.00 Denny's $10.00 7% $ L.L.Bean $25.00 16% $ Build-A-Bear Workshop 8% $ $25.00 Make Checks Payable To: HRCA Total Due All Columns: $ Family Order Form Created: 9/20/2016 3:28:51 PM Highlands Ranch Community Association Name Customer # Check # Order Date Product % QTY Total Product % QTY Total Product % QTY Total Landry's Seafood 9% $ Pappadeaux $25.00 6% $ Starbucks $25.00 7% $ $25.00 Payless Shoes $20.00 13% $ Steak 'n Shake $10.00 8% $ Landry's, Inc. $25.00 9% $ Peet's Coffee & Tea 8% $ Stein Mart $25.00 7% $ Lands' End $25.00 16% $ $20.00 SUBWAY® Restaurants 6% $ Lands' End Kids $25.00 16% $ Pei Wei Asian Diner 8% $ $10.00 $25.00 Little Caesar's Pizza 8% $ Supercuts $25.00 8% $ $20.00 PetSmart $25.00 4% $ Sweet Tomatoes $25.00 8% $ Lowe's $20.00 4% $ Pier 1 Imports $25.00 9% $ T.J. Maxx $25.00 7% $ Lowe's $25.00 4% $ Pizza Hut (Not AK or HI) 8% $ $10.00 T.J. 7% $ Macaroni Grill $25.00 11% $ Pottery Barn $25.00 8% $ Maxx/Marshalls/HomeG oods $25.00 Macaroni Grill $50.00 11% $ Qdoba Mexican Grill 7% $ Taco Bell $10.00 5% $ Macy's $25.00 10% $ $25.00 Red Lobster ® $25.00 9% $ Talbots $25.00 13% $ Maggiano's Little Italy 11% $ $25.00 Red Robin $25.00 9% $ Target $100.00 2.5% $ Marshalls $25.00 7% $ Red Sushi $25.00 9% $ Target $25.00 2.5% $ McCormick & Schmick's 9% $ Target $50.00 2.5% $ $25.00 Regal Theatres $25.00 8% $ Men's Wearhouse 8% $ Regal Theatres 10% $ Texas Roadhouse 8% $ $25.00 Premiere Movie Ticket $25.00 $10.00 Morton's Steakhouse 9% $ TGI Fridays $25.00 9% $ $25.00 REI $25.00 8% $ The Home Depot 4% $ Neiman Marcus $50.00 12% $ Rite Aid $25.00 4% $ $25.00 Toys"R"Us $20.00 3% $ Nike $25.00 12% $ Rock Bottom 6% $ Restaurant $25.00 Noodles & Company 8% $ ULTA $25.00 4% $ $10.00 Ross Dress for Less 8% $ $25.00 Under Armour $25.00 11% $ Office Depot / Office 5% $ Max $25.00 Ruth's Chris Steak 10% $ United Artist Theatres 8% $ House $50.00 Old Chicago $25.00 6% $ $25.00 Safeway $100.00 4% $ Walgreens $25.00 6% $ Old Navy $25.00 14% $ Safeway $25.00 4% $ Walmart $100.00 2.5% $ Olive Garden ® $25.00 9% $ Sally Beauty Supply 12% $ Walmart $25.00 2.5% $ On The Border $25.00 11% $ $25.00 Wendy's $10.00 4% $ Outback Steakhouse 8% $ Saltgrass Steakhouse 9% $ $25.00 $25.00 Whole Foods Market 3% $ Outback Steakhouse 8% $ Sam's Club $100.00 2.5% $ $100.00 $50.00 Sam's Club $25.00 2.5% $ Whole Foods Market 3% $ Overstock.com $25.00 8% $ $25.00 Sears $25.00 4% $ Williams-Sonoma 8% $ P.F. Chang's China 8% $ $25.00 Bistro $25.00 Sephora $20.00 5% $ Panda Express $25.00 8% $ Smashburger $10.00 10% $ Panera Bread $10.00 9% $ Sprouts Farmers Market 5% $ $25.00 Panera Bread $25.00 9% $ Sprouts Farmers Market 5% $ Papa John's Pizza 8% $ $50.00 $10.00 Staples $25.00 5% $ Papa Murphy's Pizza 8% $ $10.00 Starbucks $10.00 7% $ Make Checks Payable To: HRCA Total Due All Columns: $.