2018 OrderForm

	A	C	D	E	H	I	J	K	L
1	Prairie PTA SCRIP Program - Individual Family Order Form
2	Simply mark your quantity of which gift card(s) you would like, total your amount, and send the order form with check/cash to school OR go to www.shopwithscrip.com and use code: EB64484L25513. Questions? Contact Lisa Franz at lbfranz2003@gmail.com or text/call (317)409-6647
3	NAME:					PHONE:		Total QTY	Total DUE
4	EMAIL:					CHECK#:
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6	Product	%	QTY	Total	Product		%	QTY	Total
7	Clothing & Accessories				Electronics & Office
8	Claire's $10.00	9%		$	Best Buy® $25.00		4%		$
9	Famous Footwear $25.00	8%		$	GameStop $25.00		3%		$
10	Lands' End $25.00	15%		$	Entertainment
11	Old Navy/GAP $25.00	14%		$	AMC Theatres® $25.00		8%		$
12	Ross Dress for Less $25.00	8%		$	Barnes & Noble $10.00		8%		$
13	T.J. Maxx/Marshalls/HomeGoods $25.00	7%		$	Chuck E. Cheese $10.00		8%		$
14	Charming Charlie	11%		$	Dave & Buster's $25.00		13%		$
15	Kohl's $25.00	4%		$	Marcus Theatres $25.00		9%		$
16	Dining - Casual				Gas & Auto
17	Pizza Ranch	8%		$	BP $50.00		1.5%		$
18	Olive Garden	8%		$	Exxon $50.00		1%		$
19	Buffalo Wild Wings $25.00	8%		$	Kwik Trip $50.00		4%		$
20	Cheesecake Factory $25.00	5%		$	Marathon $25.00		3%		$
21	Chili's Grill & Bar $25.00	11%		$	Mobil $50.00		1%		$
22	Red Robin $25.00	8%		$	Shell $25.00		1.50%		$
23	Texas Roadhouse $25.00	8%		$	Speedway $25.00		4%		$
24	Dining - On The Go				Grocery
25	Noodles & Company	8%		$	Meijer $25.00		3%		$
26	Cousins Subs $10.00	9%		$	Pick 'n Save/Roundy's $25.00		4%		$
27	Culver's $10/$25	10%		$	Sentry $50.00		3%		$
28	Dairy Queen $10.00	3%		$	Health & Beauty
29	Domino's $10.00	8%		$	Bath & Body Works $25.00		12%		$
30	Dunkin' Donuts $10/$25	3%		$	CVS Pharmacy $25.00		6%		$
31	Einstein Bros. Bagels $10.00	10%		$	ULTA $25.00		4%		$
32	Panera Bread $10/$25	8%		$	Online & Catalog
33	Papa John's Pizza $10.00	8%		$	Amazon.com $25/$100		2.25%		$
34	Papa Murphy's Pizza $10.00	8%		$	Groupon.com $25.00		7%		$
35	Pizza Hut $10.00	8%		$	iTunes® $15.00/$25.00		5%		$
36	Qdoba Mexican Grill $25.00	7%		$	Shutterfly $25.00		9%		$
37	Starbucks $10/$25	7%		$	Specialty Retailer
38	SUBWAY® Restaurants $10.00	6%		$	Petco $10.00		5%		$
39	Taco Bell $10.00	5%		$	Build-A-Bear Workshop $25.00		8%		$
40	Discount Store				Container Store $25.00		9%		$
41	Mills Fleet Farm $25.00	3.5%		$	Oriental Trading Company $25.00		9%		$
42	Target $25.00	2.5%		$	Sporting Goods
43	Walmart $25.00	2.5%		$	Bass Pro Shops $25.00		8%		$
44	Home Décor & Home Improvement				Cabela's $25.00		8%		$
45	Bed Bath & Beyond $25.00	7%		$	Dick's Sporting Goods $25.00		8%		$
46	Pier 1 Imports $25.00	9%		$	Miscellaneous
47	Menards $25.00	3%		$	TANGER OUTLETS $25		8%		$
48	The Home Depot $25.00	4%		$	Discover® Universal Gift Card $50.00		1.25%		$
49	Travel/Accommodations
50	American Airlines $100/$500	6%		$	Hilton $100/$500		2%		$
51	Delta Airlines $250	4%		$	Comfort Inn $50/$100		3%		$
52	Southwest Airlines - ScripNow	4%	SEE Website		Air BNB		5%		$
53	Avis Car Rental $50	8%		$	Grand Geneva Resort $25/$100		8%		$
54	Budget Car Rental $50	8%		$	DISNEY $25/$100		3%		$
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