| A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z | |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1 | SCRIP ORDER FORM | OFFICE USE ONLY | ||||||||||||||||||||||||
2 | Holy Trinity Catholic School | Filled by__________ | ||||||||||||||||||||||||
3 | Checked by_______ | |||||||||||||||||||||||||
4 | ALL INFORMATION MUST BE COMPLETED | |||||||||||||||||||||||||
5 | Date___________________ | Limited Time Denominations: | ORDER TOTAL | All Sales Final- No Exchanges | ||||||||||||||||||||||
6 | Name_________________________________ | In Stock: ** | make checks payable to: | |||||||||||||||||||||||
7 | E-Mail/Contact Number___________________ | School delivery | Holy Trinity PTO SCRIP Program | |||||||||||||||||||||||
8 | Profit Allocation **50% Family/50% PTO | Child's Name _________________ | Form Updated 11/04/2021 | |||||||||||||||||||||||
9 | Grade and Teacher ____________ | |||||||||||||||||||||||||
10 | ITEMS IN-STOCK | RESTAURANTS cont | PROFIT | $ | QTY | TOTAL | RETAIL | PROFIT | $ | QTY | TOTAL | |||||||||||||||
11 | GROCERY | PROFIT | $ | QTY | TOTAL | Christopher's | 10% | $25 | Ace Hardware | 4% | $25 | |||||||||||||||
12 | Price Chopper | 3% | $25 | Cold Stone Creamery | 11% | $10 | Amazon.com | 2% | $10 | |||||||||||||||||
13 | Price Chopper | 3% | $100 | Curbin Cuisine | 10% | $25 | Amazon.com | 2% | $25 | |||||||||||||||||
14 | Hy-Vee/Drugtown | 3% | $25 | Dam Pub | 10% | $25 | Amazon.com | 2% | $100 | ` | ||||||||||||||||
15 | Hy-Vee/Drugtown | 3% | $100 | DQ | 3% | $10 | Apple Store | 5% | $15 | |||||||||||||||||
16 | Fareway | 3% | $10 | Domino’s Pizza | 8% | $10 | Apple Store | 5% | $25 | |||||||||||||||||
17 | Fareway | 3% | $25 | Dunkin Donuts | 3% | $10 | Barnes and Noble | 8% | $10 | |||||||||||||||||
18 | Fareway | 3% | $100 | Fazoli's | 7% | $25 | Barnes and Noble | 8% | $25 | |||||||||||||||||
19 | Target | 2.5% | $10 | Gilroy's | 10% | $25 | Bass Pro Shops | 8% | $25 | |||||||||||||||||
20 | Target | 2.5% | $25 | Grounds for Celebration | 10% | $10 | Bath & Body Works | 12% | $10 | |||||||||||||||||
21 | Target | 2.5% | $50 | Hardee's | 5% | $10 | Bath & Body Works | 13% | $25 | |||||||||||||||||
22 | Target | 2.5% | $100 | IHOP | 8% | $10 | Beaverdale Books | 10% | $25 | |||||||||||||||||
23 | Wal-Mart/Sam's | 2.5% | $10 | IHOP | 8% | $25 | Bed Bath & Beyond | 7% | $25 | |||||||||||||||||
24 | Wal-Mart/Sam's | 2.5% | $25 | Little Ceasars | 8% | $20 | Best Buy | 4% | $25 | |||||||||||||||||
25 | Wal-Mart/Sam's | 2.5% | $100 | Long John Silvers | 8% | $10 | Boesen's Florist | 10% | $10 | |||||||||||||||||
26 | GAS | PROFIT | $ | QTY | TOTAL | McAllisters | 6% | $25 | Dick's Sporting Goods | 8% | $25 | |||||||||||||||
27 | Casey's | 3% | $25 | McDonalds ** | 5% | $5 | Discover | 1.25% | $50 | |||||||||||||||||
28 | Casey's | 3% | $100 | McDonalds | 5% | $10 | Discover | 1% | $100 | |||||||||||||||||
29 | Kum & Go | 5% | $25 | Noodles | 8% | $10 | FleetFarm | 3.5% | $25 | |||||||||||||||||
30 | Kum & Go | 5% | $50 | Old Chicago | 6% | $25 | Gap/Old Navy/Ban Rep | 14% | $25 | |||||||||||||||||
31 | Kum & Go | 5% | $100 | Olive Garden/Darden | 8% | $25 | Great Clips | 8% | $25 | |||||||||||||||||
32 | Kwik Star | 4% | $25 | Panera Bread (seasonal) | 8% | $5 | Happy Dining | 8% | $25 | |||||||||||||||||
33 | Kwik Star | 4% | $50 | Panera Bread | 8% | $10 | Home Depot (seasonal) | 4% | $10 | |||||||||||||||||
34 | RESTAURANTS | PROFIT | $ | QTY | TOTAL | Papa John's | 8% | $10 | Home Depot | 4% | $25 | |||||||||||||||
35 | Applebee's | 8% | $25 | Papa Murphy's | 8% | $10 | Home Depot | 4% | $100 | |||||||||||||||||
36 | Arbys | 8% | $10 | Pizza Hut | 8% | $10 | Kohl's | 4% | $25 | |||||||||||||||||
37 | B-Bops | 10% | $10 | Pizza Ranch | 8% | $25 | Kohl's | 4% | $100 | |||||||||||||||||
38 | Beaverdale Confections | 10% | $5 | Red Robin | 8% | $25 | LL Bean | 16% | $25 | |||||||||||||||||
39 | Blaze Pizza | 10% | $25 | Ruby Tuesday | 8% | $25 | Lands End | 15% | $25 | |||||||||||||||||
40 | Bonefish/Outback | 8% | $25 | Smashburger | 10% | $10 | Lowes | 4% | $25 | |||||||||||||||||
41 | Brueggers | 7% | $10 | Starbucks (seasonal) | 4.5% | $5 | Lowes | 4% | $100 | |||||||||||||||||
42 | Buffalo Wild Wings | 8% | $10 | Starbucks | 4.5% | $10 | Menards | 3% | $25 | |||||||||||||||||
43 | Buffalo Wild Wings | 8% | $25 | Starbucks | 4.5% | $25 | Michaels | 4% | $25 | |||||||||||||||||
44 | Burger King | 4% | $10 | Steak 'n Shake | 8% | $10 | RayGun | 10% | $25 | |||||||||||||||||
45 | Caribou Coffee | 6% | $10 | Subway | 6% | $10 | Scheels | 8% | $25 | |||||||||||||||||
46 | Chili's/Macaroni Grill | 11% | $25 | Taco Bell | 5% | $10 | Shutterfly | 9% | $25 | |||||||||||||||||
47 | Chipotle | 10% | $10 | Texas Roadhouse | 8% | $25 | TJ MAXX/Marshalls | 7% | $25 | |||||||||||||||||
48 | Wendy's | 4% | $10 | Ulta | 4% | $25 | ||||||||||||||||||||
49 | Walgreens | 5% | $25 | |||||||||||||||||||||||
50 | Walgreens | 5% | $100 | |||||||||||||||||||||||
51 | ITEMS AVAILABLE TO ORDER | |||||||||||||||||||||||||
52 | ||||||||||||||||||||||||||
53 | RESTAURANTS | PROFIT | $ | QTY | TOTAL | RETAIL | PROFIT | $ | QTY | TOTAL | RETAIL | PROFIT | $ | QTY | TOTAL | |||||||||||
54 | Bob Evans | 10% | $10 | Aeropostale | 10% | $25 | Groupon | 7% | $25 | |||||||||||||||||
55 | Boston Market | 12% | $10 | Airbnb | 5% | eGift | Hilton Hotels | 2% | $100 | |||||||||||||||||
56 | Bravo | 12% | $25 | Albertson | 4% | $25 | J. Crew | 13% | $25 | |||||||||||||||||
57 | Cheesecake Factory | 5% | $25 | AMC Theatres | 8% | $25 | JC Penney | 5% | $25 | |||||||||||||||||
58 | Chuck E. Cheese | 8% | $10 | American Airlines | 6% | $100 | JC Penney | 5% | $100 | |||||||||||||||||
59 | Cold Stone Creamery | 11% | $10 | American Eagle | 10% | $25 | Jewel Osco | 4% | $25 | |||||||||||||||||
60 | Cracker Barrel | 8% | $10 | American Girl | 9% | $25 | Jo-Ann Fabrics | 6% | $25 | |||||||||||||||||
61 | Dennys | 7% | $10 | Athleta | 14% | $25 | L.L. Bean | 16% | $100 | |||||||||||||||||
62 | Mimi's Café | 8% | $25 | Auto Zone | 8% | $25 | Homegoods/TJ Maxx | 7% | $100 | |||||||||||||||||
63 | O'Charley's | 13% | $25 | Bass Pro Shops | 10% | $100 | Marriott Hotels & Resorts | 6% | $100 | |||||||||||||||||
64 | P.F. Chang's | 8% | $25 | Cabela's | 10% | $25 | Maurices | 7% | $20 | |||||||||||||||||
65 | Cabela's | 10% | $100 | Men's Wearhouse | 8% | $25 | ||||||||||||||||||||
66 | Carnival Cruise Lines | 8% | $100 | Mill's Fleet Farm | 3.5% | $25 | ||||||||||||||||||||
67 | Century Theaters | 4% | $25 | Nike Outlet | 12% | $25 | ||||||||||||||||||||
68 | Chico's | 6.5% | $25 | Nordstroms | 4% | varies | ||||||||||||||||||||
69 | Claire's | 9% | $10 | Office Depot | 5% | $25 | ||||||||||||||||||||
70 | See www.shopwithscrip.com for more vendors | Comfort Inn | 3% | $50 | Office Depot | 5% | $100 | |||||||||||||||||||
71 | look for those with physical cards OR sign up | Comfort Inn | 3% | $100 | Old Navy | 14% | $25 | |||||||||||||||||||
72 | for Presto Pay to use the ScripNow function. | Comfort Suites | 3% | $50 | Outback | 10% | $25 | |||||||||||||||||||
73 | Comfort Suites | 3% | $100 | Overstock.com | 8% | $25 | ||||||||||||||||||||
74 | Container Store | 9% | $25 | Sephora | 5% | $25 | ||||||||||||||||||||
75 | FILLING SCHEDULE: | Crate & Barrel | 8% | $25 | Shoe Carnival | 5% | $25 | |||||||||||||||||||
76 | MONDAYS | Delta Airlines | 4% | $250 | Southwest Airlines | 4% | $250 | |||||||||||||||||||
77 | IN STOCK items are filled and sent home | Dick's Sporting Goods | 8% | $100 | Staples | 5% | $25 | |||||||||||||||||||
78 | OUT-OF-STOCK items are ordered. | Dillards | 9% | $25 | Staples | 5% | $100 | |||||||||||||||||||
79 | THURSDAYS | Disney | 3% | $25 | Supercuts | 8% | $25 | |||||||||||||||||||
80 | OUT-OF-STOCK items are filled & delivered. | Disney | 3% | $100 | Talbots | 13% | $25 | |||||||||||||||||||
81 | IF NO SCHOOL ON MONDAY ORDERS WILL | Express/Structure | 10% | $25 | T.J. Maxx | 7% | $100 | |||||||||||||||||||
82 | BE FILLED ON TUESDAY | Famous Footwear | 8% | $25 | Visa Gift Card | 1.25% | $50 | |||||||||||||||||||
83 | Saturday and Sunday | Finish Line | 10% | $25 | Under Armour | 11% | $25 | |||||||||||||||||||
84 | SCRIP is sold after each Mass. Cash and Carry. | Foot Locker/Lady's/Kids | 8% | $25 | Wayfair | 6% | $100 | |||||||||||||||||||
85 | Game Stop | 3% | $25 | Whole Foods Market | 3% | eGift | ||||||||||||||||||||
86 | Great Clips | 8% | $25 | |||||||||||||||||||||||
87 | ||||||||||||||||||||||||||
88 | ||||||||||||||||||||||||||
89 | ||||||||||||||||||||||||||
90 | ||||||||||||||||||||||||||
91 | ||||||||||||||||||||||||||
92 | ||||||||||||||||||||||||||
93 | ||||||||||||||||||||||||||
94 | ||||||||||||||||||||||||||
95 | ||||||||||||||||||||||||||
96 | ||||||||||||||||||||||||||
97 | ||||||||||||||||||||||||||
98 | ||||||||||||||||||||||||||
99 | ||||||||||||||||||||||||||
100 |