FAMILY FORM CONTACT Phone SUPPORT Revision 1-Oct-2016 Order Date DD-MON-YYYY Required DD-MON-YYYY DEN SUB-TOTAL QTY Amazon.ca 50 2.0% American Eagle, Aerie, 77kids 25 5.0% Bass Pro Shops 50 7.0% Bath & Body Works 25 7.0% Best Buy also available in $100 and $500 25 2.0% Best Western International 50 3.5% The Body Shop while quantities last 25 5.0% Boston Pizza 25 7.0% Canadian Tire, Canadian Tire Gas Bar 25 4.0% P O U G R V E S N T I EN C I EN A V G 50 4.0% 100 4.0% Cara - Bier Market, Casey's, Fionn MacCool's, Harvey's, Kelsey's, Mario's, 25 5.0% Milestones, Montana's, Swiss Chalet 50 5.0% Chapter's, Indigo, Coles, World's Biggest Book Store 10 7.0% 25 7.0% The Children's Place 25 9.0% Cineplex, Galaxy, Famous, Coliseum, SilverCity, Colossus, Paramount Admit One 10.5 6.0% Cineplex, Galaxy, Famous, Coliseum, SilverCity, Colossus, Paramount Child's Night Out 15 9.0% Cineplex Gift Card also available in $10 25 5.0% Earls Restaurants 25 7.0% Esso, On The Run 25 2.5% 50 2.5% 100 2.5% Fairmont Hotels 50 10.0% The Gap, Gap Kids, Baby Gap, Old Navy, Banana Republic 25 7.0% Giant Tiger, Tigre Geant, Scott's Discount, Chez Tante Marie 25 3.5% The Home Depot also available in $500 25 3.0% 100 3.0% Home Hardware also available in $500 25 3.5% 100 3.5% HBC - The Bay, Zellers, Home Outfitters 25 3.5% 100 3.5% Joey Restaurants 25 7.0% The Keg 25 8.0% 50 8.0% 100 8.0% Kernels Popcorn - get a two for one coupon with each gift card 10 7.0% Landmark Cinemas General Admission 10 6.5% Landmark Cinemas Kid's Adventure Pass 12 12.5% La Senza, La Senza Girl, Silk and Satin 25 7.0% Laura Secord 25 10.0% Loblaws, No Frills, Zehrs, Fortinos, Valu-mart, Extra Foods, Independent, 50 3.5% Atlantic / Real Canadian Superstore, Maxi, Provigo, Real Canadian Wholesale, 100 3.5% National Grocers, SaveEasy, SuperValu 250 3.5% Longos 50 3.5% Lowe's Canada 100 2.0% Mark's Work Warehouse, L'Equipeur 25 7.0% Metro, Food Basics also available in $25 50 4.0% 100 4.0% M & M Meat Shops 25 4.0% Moores 25 5.0% Moxies Classic Grill 25 10.0% Payless ShoeSource 25 10.0% Petro-Canada also available in $500 25 3.0% 50 3.0% 100 3.0% Pier 1 Imports 25 5.0% Pioneer Petroleums 50 1.5% Pizza Pizza, Pizza 73 25 10.0% Red Lobster 25 7.0% Rona, Reno-Depot, Totem Building Supplies, Botanix, Chester DAWE also 25 5.0% available in $500 100 5.0% Roots, Roots Kids, Baby Roots, Roots Home 25 15.0% Safeway 50 will be replaced with Sobeys. 25 & 100 Safeway still avail. 50 4.0% Sears, Sears Home, Sears Travel 25 3.5% 100 3.5% Shell Canada 50 2.0% Sheridan Nurseries 25 4.0% The Shoe Company, Town Shoes, DSW, Shoe Warehouse 25 7.0% Shoppers Drug Mart / Pharmaprix 25 3.0% 100 3.0% SIR CORP - Jack Astor's, Alice Fazooli's, Far Niente, Reds, Canyon Creek, The Loose Moose 25 10.0% Sobeys, IGA (except in BC), Price Chopper, Foodland, 25 4.0% FreshCo, Lawtons Drugs, Thrifty Foods, Safeway, Needs 50 4.0% also available in $250 100 4.0% Sport Chek, Coast Mountain Sports, Nevada Bobs in Sport Check 25 3.0% Staples Business Depot 25 3.0% 100 3.0% Starbucks also available in $10 and $50 25 5.0% Subway 25 3.0% Tim Hortons also available in $10, $15, $20 25 4.0% 50 4.0% TOYS R US, BABIES R US 25 2.0% Ultramar Gas 50 2.5% Walmart also available in $25 and $250 50 2.0% 100 2.0% WaySpa 50 15.0% Wendy's Restaurants 25 3.0% Winners, Home Sense, Marshalls 25 8.0% 100 8.0% You can overwrite this line and next 7 lines to add Extra Items Just follow the instructions that pop up. Include the correct discount! CLEARANCE ITEMS BELOW - SEE EXTRA ITEMS LIST RAINBOW CINEMAS, MAGIC LANTERN $5 - 40 available SUNRISE RECORDS $25 - 7 available TIP TOP TAILORS $25 - 1 available Estimated Profit Count 0 ### 0.00 PLEASE SEND THIS FORM TO YOUR ADMINISTRATOR Remit to Group ### 0.00.