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SCRIP ORDER FORM
OFFICE USE ONLY
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Holy Trinity Catholic School
Filled by__________
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Checked by_______
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ALL INFORMATION MUST BE COMPLETED
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Date___________________
Limited Time Denominations:
ORDER TOTAL
All Sales Final- No Exchanges
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Name_________________________________
In Stock: **
make checks payable to:
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E-Mail/Contact Number___________________
School delivery
Holy Trinity PTO SCRIP Program
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Profit Allocation **50% Family/50% PTO
Child's Name _________________
Form Updated 11/04/2021
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Grade and Teacher ____________
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ITEMS IN-STOCKRESTAURANTS contPROFIT$QTYTOTALRETAILPROFIT$QTYTOTAL
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GROCERYPROFIT$QTYTOTALChristopher's10%$25Ace Hardware4%$25
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Price Chopper3%$25 Cold Stone Creamery11%$10Amazon.com2%$10
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Price Chopper3%$100 Curbin Cuisine10%$25Amazon.com2%$25
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Hy-Vee/Drugtown 3%$25Dam Pub10%$25Amazon.com2%$100`
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Hy-Vee/Drugtown 3%$100DQ3%$10Apple Store5%$15
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Fareway3%$10Domino’s Pizza8%$10Apple Store5%$25
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Fareway3%$25Dunkin Donuts3%$10Barnes and Noble8%$10
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Fareway3%$100Fazoli's7%$25Barnes and Noble8%$25
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Target2.5%$10Gilroy's10%$25Bass Pro Shops8%$25
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Target2.5%$25Grounds for Celebration 10%$10Bath & Body Works12%$10
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Target2.5%$50Hardee's5%$10Bath & Body Works13%$25
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Target2.5%$100IHOP8%$10Beaverdale Books10%$25
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Wal-Mart/Sam's2.5%$10IHOP8%$25Bed Bath & Beyond7%$25
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Wal-Mart/Sam's2.5%$25Little Ceasars8%$20Best Buy4%$25
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Wal-Mart/Sam's2.5%$100Long John Silvers8%$10Boesen's Florist 10%$10
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GASPROFIT$QTYTOTALMcAllisters6%$25Dick's Sporting Goods8%$25
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Casey's 3%$25McDonalds **5%$5Discover1.25%$50
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Casey's 3%$100 McDonalds 5%$10Discover1%$100
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Kum & Go 5%$25Noodles8%$10FleetFarm3.5%$25
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Kum & Go 5%$50Old Chicago6%$25Gap/Old Navy/Ban Rep14%$25
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Kum & Go 5%$100 Olive Garden/Darden8%$25Great Clips8%$25
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Kwik Star4%$25 Panera Bread (seasonal)8%$5Happy Dining8%$25
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Kwik Star4%$50 Panera Bread8%$10Home Depot (seasonal)4%$10
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RESTAURANTSPROFIT$QTYTOTALPapa John's8%$10Home Depot4%$25
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Applebee's 8%$25Papa Murphy's8%$10 Home Depot4%$100
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Arbys8%$10Pizza Hut 8%$10Kohl's 4%$25
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B-Bops10%$10Pizza Ranch8%$25Kohl's 4%$100
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Beaverdale Confections10%$5Red Robin8%$25LL Bean16%$25
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Blaze Pizza10%$25Ruby Tuesday8%$25 Lands End 15%$25
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Bonefish/Outback8%$25Smashburger10%$10 Lowes4%$25
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Brueggers7%$10Starbucks (seasonal)4.5%$5Lowes4%$100
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Buffalo Wild Wings8%$10Starbucks 4.5%$10Menards3%$25
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Buffalo Wild Wings8%$25Starbucks 4.5%$25Michaels4%$25
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Burger King 4%$10Steak 'n Shake8%$10RayGun10%$25
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Caribou Coffee6%$10Subway6%$10Scheels8%$25
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Chili's/Macaroni Grill11%$25Taco Bell5%$10Shutterfly9%$25
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Chipotle10%$10Texas Roadhouse8%$25TJ MAXX/Marshalls7%$25
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Wendy's 4%$10Ulta4%$25
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Walgreens5%$25
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Walgreens5%$100
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ITEMS AVAILABLE TO ORDER
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RESTAURANTSPROFIT$QTYTOTALRETAIL
PROFIT
$QTYTOTALRETAILPROFIT$QTYTOTAL
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Bob Evans10%$10Aeropostale10%$25Groupon7%$25
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Boston Market12%$10Airbnb5%eGiftHilton Hotels2%$100
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Bravo12%$25Albertson4%$25J. Crew13%$25
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Cheesecake Factory5%$25AMC Theatres 8%$25JC Penney 5%$25
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Chuck E. Cheese8%$10American Airlines6%$100JC Penney 5%$100
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Cold Stone Creamery11%$10American Eagle10%$25Jewel Osco4%$25
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Cracker Barrel8%$10American Girl 9%$25Jo-Ann Fabrics6%$25
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Dennys7%$10Athleta 14%$25L.L. Bean16%$100
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Mimi's Café8%$25Auto Zone8%$25Homegoods/TJ Maxx7%$100
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O'Charley's13%$25Bass Pro Shops10%$100Marriott Hotels & Resorts6%$100
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P.F. Chang's8%$25Cabela's10%$25Maurices7%$20
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Cabela's10%$100Men's Wearhouse8%$25
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Carnival Cruise Lines8%$100Mill's Fleet Farm3.5%$25
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Century Theaters4%$25Nike Outlet12%$25
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Chico's6.5%$25Nordstroms4%varies
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Claire's9%$10Office Depot5%$25
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See www.shopwithscrip.com for more vendors
Comfort Inn3%$50Office Depot5%$100
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look for those with physical cards OR sign up
Comfort Inn3%$100Old Navy14%$25
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for Presto Pay to use the ScripNow function.
Comfort Suites3%$50Outback10%$25
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Comfort Suites3%$100Overstock.com8%$25
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Container Store9%$25Sephora5%$25
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FILLING SCHEDULE:Crate & Barrel8%$25Shoe Carnival5%$25
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MONDAYSDelta Airlines4%$250Southwest Airlines4%$250
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IN STOCK items are filled and sent home
Dick's Sporting Goods8%$100Staples5%$25
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OUT-OF-STOCK items are ordered.
Dillards9%$25Staples5%$100
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THURSDAYSDisney3%$25Supercuts8%$25
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OUT-OF-STOCK items are filled & delivered.
Disney3%$100Talbots13%$25
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IF NO SCHOOL ON MONDAY ORDERS WILL
Express/Structure10%$25T.J. Maxx7%$100
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BE FILLED ON TUESDAYFamous Footwear8%$25Visa Gift Card1.25%$50
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Saturday and SundayFinish Line10%$25Under Armour11%$25
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SCRIP is sold after each Mass. Cash and Carry.
Foot Locker/Lady's/Kids8%$25Wayfair6%$100
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Game Stop3%$25Whole Foods Market3%eGift
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Great Clips8%$25
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