| ASHLEY UNITED METHODIST CHURCH
SCRIP ORDER FORM |
|
Date: __________ |
|
On-Hand
Scrip is in Bold Italics |
|
| Name: ______________________________ |
|
|
|
|
|
|
| Grocery Stores |
|
| Store |
Amt |
% |
Qty |
Total |
|
Store |
Amt |
% |
Qty |
Total |
|
Store |
Amt |
% |
Qty |
Total |
|
| Buehler's |
$50/$100 |
4% |
|
$ |
|
Giant Eagle/GetGo |
$100 |
4% |
|
$ |
|
Omaha Steaks |
$25 |
11% |
|
$ |
|
| Gas & Auto |
|
| Store |
Amt |
% |
Qty |
Total |
|
Store |
Amt |
% |
Qty |
Total |
|
Store |
Amt |
% |
Qty |
Total |
|
| BP |
$50 |
2% |
|
$ |
|
Speedway/S.A. |
$25 |
4% |
|
$ |
|
Auto Zone |
$25 |
5% |
|
$ |
|
| Retailer |
|
| Store |
Amt |
% |
Qty |
Total |
|
Store |
Amt |
% |
Qty |
Total |
|
Store |
Amt |
% |
Qty |
Total |
|
| Ace Hardware |
$25 |
4% |
|
$ |
|
AT&T 675 minute
card |
$20 |
15% |
|
$ |
|
AMC Theatre |
$25 |
7% |
|
$ |
|
| Anderson's |
$25 |
4% |
|
$ |
|
Barnes&Noble |
$10 |
9% |
|
$ |
|
Bath & Body |
$10 |
13% |
|
$ |
|
| Best Buy |
$25 |
3% |
|
$ |
|
Blockbuster |
$3.79 |
15% |
|
$ |
|
Blckbster Nite |
$12 |
15% |
|
$ |
|
| Build A Bear |
$25 |
8% |
|
$ |
|
Cabela's |
$25 |
11% |
|
$ |
|
CVS |
$25 |
6% |
|
$ |
|
| Dick's
Sporting |
$25 |
8% |
|
$ |
|
Dunham's Sports |
25 |
8% |
|
$ |
|
EB Games |
$25 |
3% |
|
$ |
|
| Finish Line |
$25 |
10% |
|
$ |
|
Foot Locker |
$25 |
9% |
|
$ |
|
Game Stop |
$25 |
3% |
|
$ |
|
| GFS Market |
$25 |
4% |
|
$ |
|
GNC |
$25 |
8% |
|
$ |
|
Great Clips |
25 |
8% |
|
$ |
|
| Great Harvest |
$10 |
8% |
|
$ |
|
Hallmark |
$25 |
4% |
|
$ |
|
Home Depot |
$25 |
4% |
|
$ |
|
| Honey Bkd Ham |
$10 |
12% |
|
$ |
|
iTunes |
$15 |
5% |
|
$ |
|
JC Penney |
$25 |
5% |
|
$ |
|
| JoAnn Fabrics |
$20 |
6% |
|
$ |
|
Kohls |
$25 |
4% |
|
$ |
|
LL Bean |
$25 |
15% |
|
$ |
|
| Lands End |
$25 |
17% |
|
$ |
|
Lowes |
$25 |
4% |
|
$ |
|
Loews Cineplex |
$25 |
7% |
|
$ |
|
| Marcus
Theatre |
$25 |
9% |
|
$ |
|
Macy's |
$25 |
10% |
|
$ |
|
MC Sports |
25 |
8% |
|
$ |
|
| Menards |
$25 |
3% |
|
$ |
|
Office Max |
$25 |
5% |
|
$ |
|
Old Navy/Gap |
$25 |
9% |
|
$ |
|
| Payless Shoe |
$20 |
13% |
|
$ |
|
Radio Shack |
$25 |
4% |
|
$ |
|
Sally Beauty |
$25 |
12% |
|
$ |
|
| Sears/Great
Indoors |
$25 |
4% |
|
$ |
|
Shutterfly |
$25 |
9% |
|
$ |
|
Shoe Carnival |
25 |
5% |
|
$ |
|
| Staples |
$25 |
5% |
|
$ |
|
Babies/Toys-R-Us |
$20 |
1.50% |
|
$ |
|
Wal-Mart |
$25 |
2% |
|
$ |
|
| Restaurants |
|
| Applebees |
$25 |
8% |
|
$ |
|
Arby's |
$10 |
8% |
|
$ |
|
BD's Mong. BBQ |
$20 |
8% |
|
$ |
|
| Bob Evans |
$10 |
10% |
|
$ |
|
Boston Market |
$10 |
12% |
|
$ |
|
Bucca di Beppo |
$25 |
8% |
|
$ |
|
| Burger King |
$10 |
4% |
|
$ |
|
Carrabba's |
$25 |
5% |
|
$ |
|
Chscake Factory |
$25 |
5% |
|
$ |
|
| Chipotle |
$10 |
10% |
|
$ |
|
Chk E. Cheese |
$10 |
8% |
|
$ |
|
Cold Stone Crmy |
$10 |
8% |
|
$ |
|
| Cracker Barl |
$10 |
9% |
|
$ |
|
Dave & Busters |
$25 |
13% |
|
$ |
|
Domino's Pizza |
$5 |
5% |
|
$ |
|
| Dominos Pizza
& 2Ltr |
$14 |
25% |
|
$ |
|
Donatos Pizza |
$10 |
10% |
|
$ |
|
Hoggy's |
$20 |
10% |
|
$ |
|
| Hometown
Buf./Ryans |
$25 |
5% |
|
$ |
|
KFC |
$5 |
8% |
|
$ |
|
Longhorn Steakhouse |
$25 |
9% |
|
$ |
|
| Long John
Silver |
$5 |
8% |
|
$ |
|
Max & Erma's |
$20 |
13% |
|
$ |
|
McDonalds |
$5 |
5% |
|
$ |
|
| Mimi's Café |
$25 |
8% |
|
$ |
|
O'Charley's |
$25 |
13% |
|
$ |
|
Olive Garden |
$25 |
9% |
|
$ |
|
| Outback
Stkhse |
$25 |
8% |
|
$ |
|
PFChang's/PeiWei |
$25 |
8% |
|
$ |
|
Panera |
$10 |
9% |
|
$ |
|
| Papa John's |
$10 |
8% |
|
$ |
|
Pizza Hut |
$10 |
8% |
|
$ |
|
Quizno's |
$5 |
8% |
|
$ |
|
| Red Lobster |
$25 |
9% |
|
$ |
|
Red Robin |
$25 |
9% |
|
$ |
|
Ruby Tuesday |
$25 |
8% |
|
$ |
|
| Spaghetti
Whse |
$20 |
18% |
|
$ |
|
Starbucks reloadable |
$10 |
7% |
|
$ |
|
Subway |
$10 |
3% |
|
$ |
|
| Texas Rdhouse |
$25 |
8% |
|
$ |
|
Steak & Shake |
$10 |
8% |
|
$ |
|
TGI Friday's |
$20 |
9% |
|
$ |
|
| Wendy's |
$10 |
4% |
|
$ |
|
|
|
|
|
| PLEASE
MAKE CHECKS PAYABLE TO BVEE PTO |
|
|
|
|
|
TOTAL ORDER AMOUNT: |
$ |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|