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AUCTION SCRIP ORDER FORM
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Scrip purchased using this form will be delivered directly to the SFA Auction Committee.
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NAME: PHONE: DATE:
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GROCERY STORES
Profit
$Quan.
$ Total
DEPARTMENT/RETAIL STORES
Profit
$Quan.
$ Total
GAS
Profit
$Quan.
$ Total
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99 Ranch Market6%$50.00 Bath & Body Works12%$25.00 76 Gas1.5%$25.00
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Food Maxx/Lucky/Savemart2%$25.00
Bed, Bath & Beyond/buy buy Baby
7%$25.00 ARCO (fuel only)1.5%$50.00
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Food Maxx/Lucky/Savemart2%$100.00 Best Buy4%$25.00 ARCO (fuel only)1.5%$100.00
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Nob Hill/Raley's/Bel Air4%$25.00 Big 5 Sporting Goods8%$25.00 Chevron (CA only)1%$50.00
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Nob Hill/Raley's/Bel Air4%$100.00 Carter's/Osh Kosh10%$25.00 Chevron (CA only)1%$100.00
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Safeway/Albertson's/Vons4%$25.00 Crate & Barrel8%$25.00 Exxon/Mobil1%$50.00
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Safeway/Albertson's/Vons4%$50.00 DSW8%$25.00 Shell1.5%$50.00
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Safeway/Albertson's/Vons4%$100.00 Dennis Uniform6%$20.00 Shell1.5%$100.00
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Smart & Final3%$50.00 Dick's Sporting Goods8%$25.00TOYS/GAMES
Profit
$Quan.
$ Total
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Sprouts Farmers Market5%$50.00
Gap/Old Navy/Banana Republic
14%$25.00 American Girl9%$25.00
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Sprouts Farmers Market5%$100.00
Jo-Ann Fabric and Craft Store
6%$25.00 Disney3%$25.00
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Walmart/Sam's Club2.5%$100.00
Kohl's (May be used to pay on acct.)
4%$25.00 Disney3%$100.00
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BEVERAGES/COFFEE/TEA
Profit
$Quan.
$ Total
Kohl's (May be used to pay on acct.)
4%$100.00
Game Stop/Babbage's/Funcoland
3%$25.00
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Starbucks4.5%$10.00 Lowe's4%$25.00MOVIES/MUSIC
Profit
$Quan.
$ Total
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Starbucks4.5%$25.00 Lowe's4%$100.00 Barnes & Noble8% $ 25.00
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Starbucks4.5%$50.00 Macy's10%$25.00 Century Theatres 4%$25.00
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RESTAURANTS/FOOD
Profit
$Quan.
$ Total
Macy's10%$100.00
Century Theatres Single Ticket
8.5%$11.00
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7 Option card - Auntie Anne's; Carvel, Cinnabon, Jamba Juice,
Michael's4%$25.00 Fandango4%$25.00
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McAlister's Deli, Moe's,Schlotzky's
6%$25.00 Nike12%$25.00 iTunes5%$25.00
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Burger King4%$10.00
Nordstrom/Nordstrom Rack/Hautelook
5%$25.00On-Line
Profit
$Quan.
$ Total
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California Pizza Kitchen8%$25.00
Nordstrom/Nordstrom Rack/Hautelook
5%$100.00 Amazon.com1.7%$25.00
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Carl's Jr.5%$10.00 Office Max/Office Depot5%$25.00 Amazon.com1.7%$100.00
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Cheesecake Factory5%$25.00 Pet Smart 5%$25.00DRUG STORES
Profit
$Quan.
$ Total
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Chili's Grill & Bar11%$25.00 REI Sporting Goods8%$25.00 CVS6%$25.00
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Chipotle Mexican Grill10%$25.00 Ross Dress for Less8%$25.00 Walgreen's5%$25.00
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Chuck E. Cheese8%$10.00 Sephora5%$25.00
Payment: (Cash or Check payable to St. Francis of Assisi School)
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Cold Stone Creamery11%$10.00 Staples5%$25.00
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Dairy Queen3%$10.00 Target2.5%$10.00
o CASH o CHECK #___________
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Dunkin Donuts3%$10.00 Target2.5%$25.00
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Honey Baked Ham12%$25.00 Target2.5%$50.00
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Krispy Kreme Doughnuts8%$10.00 Target2.5%$100.00
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Noah's Bagels/Einstein Bros.
10%$10.00 The Home Depot4%$25.00
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Olive Garden/Yard House8%$25.00 The Home Depot4%$100.00
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Outback Steakhouse/Fleming's
8%$25.00
TJMaxx/Marshall's/Home Goods
7%$25.00
Enclosed is my $____________ donation.
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P.F. Chang's China Bistro6%$25.00
TJMaxx/Marshall's/Home Goods
7%$100.00
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Panda Express8%$25.00 ULTA7%$25.00
Please allow the SFA Auction Committee
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Panera Bread8%$10.00
William Sonoma/Pottery Barn
8%$25.00
to choose the gift card(s) of their choice.
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Panera Bread8%$25.00UNIVERSAL PREPAID CARDS
Profit
$Quan.
$ Total
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Rocco's10%$25.00 VISA (No Activation Fee)1.25%$50.00
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Ruth's Chris Steakhouse10%$50.00 VISA (No Activation Fee)1.25%$100.00
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See's Candy9%$25.00 VISA (No Activation Fee)1.25%$250.00
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Subway4.5%$10.00Comments/Questions:
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Taco Bell5%$10.00
Scrip Coordinator: Fran Del Prete
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fadp711@aol.com
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925-408-6782
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