In-Stock Order Form
Last Name First Name
Phone number Date
Student/family to receive credit
If you do not designate a family to receive credit, the money will be added to the Angel Fund.
*disc. shown is after 1% deducted for administrative costs
Grocery Stores Disc.* $ Qty Total
Retail/Specialty Stores Disc.* $ Qty Total
Giant Eagle/GetGo 4% $10
American Eagle 8% $25
Giant Eagle gift cards can be $25
Barnes and Noble 8% $10
used at GetGo and vice-versa $50
$25
$100
Bath and Body 12% $10
Shop N Save 4% $10
$25
$25
Bed Bath and Beyond 6% $25
$50
Borders/Waldenbooks 8% $10
McGinnis Sisters 4% $25
$25
Food Outlets Disc.* $ Qty Total
Dick's Sporting Goods 4% $25
Atria’s Restaurant 9% $25 Dunham’s Sports 7% $25
Bruegger’s Bagels 4% $10 Gap/Old Navy/Banana Republic 8% $25
Eat 'n Park 9% $10
J. Crew 12% $25
$25
JCPenney (can be used to pay 4% $25
Max & Erma's 12% $20
credit card) $100
Molly Brannigan’s 14% $20
Kohl’s (can be used to pay 4% $10
Panera Bread 8% $10
credit card) $25
Pizza Hut 8% $10
$50
Primadonna 9% $25
$100
Red Lobster/Olive Garden 8% $25
Lands' End 8% $25
Starbucks 6% $10
L.L Bean 14% $25
$25
Macy's 8% $25
Subway 2% $10
$100
Wendy’s 3% $10
Marshalls/TJ Maxx 6% $25
Write- in vendors Disc.* $ Qty Total
$100
Michael’s 3% $25
Payless Shoes 12% $20
Rollier’s Hardware 4% $20
$50
WalMart/ Sam’s Club 1% $25
$100
Make checks payable to:
Shop For Education Total
If you are sending this order with a St. Bernard’s student, complete the following and enclose form and payment in an envelope:
□ I will pick up my order in the band room between 2:30 and 2:55 on Wednesday afternoon.
□ I hereby give permission for the gift certificates/cards purchased to be sent home in Wed.’s blue folder with my child
Room/Teacher _______________ . I understand by
having them sent home with my child, St. Bernard School will not be held accountable if they are lost or stolen.
Signed Date
** In the event we are out of the denominations you requested, we will attempt to fill your order with the denominations that are available.
updated 1.9.08
For Office Use: Chk. # ____________ or Cash $____________
Order reviewed and in-stock filled by _______ /_______ __________
initial s date
Order completed by _______/_______ __________
Updated 1.9.08 initials date