scrip_order by xiangpeng

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									                                                   Nazareth School Scrip Program
                                                              SCRIP ORDER FORM
                 DATE                               _                          DAYTIME PHONE                                         _

        FAMILY NAME                             ,---                                           _          CHILD'S GRADE                              _
                                               Please Print
 GROCERY STORES                                           AMOUNT                   RETAIL I SPECIALTY STORES                                         AMOUNT
 Albertson's                       ($25,   $100)                                   AMC Theaters                         ($25)
 Smart & Final                     ($25,   $100)                                   Barnes and NoblelB. Dalton           ($10)
 Stater Bros.                      ($25,   $100)                                   Blockbuster                          ($10)
 Von's                             ($25,   $100)                                   BordersIWaldenbooks                  ($10)
 RESTAURANTS & FOOD                                                                Dennis Uniform                       ($20)
 Applebees                               ($25)                                     Gap/Old NavylBanana Republic         ($25)
 Baskin Robbins                           ($2)                                     Home Depot               ($25, $100, $500)
 Black Angus                             ($20)                                     iTnnes                               ($15)
 Burger King                             ($10)                                     JC Penney *                    ($25, $100)
 Carl's Jr.                              ($10)                                     Lowe's                         ($25, $100)
 Cheesecake Factory                      ($25)                                     Kohl's                         ($25, $100)
 Chili'siOn the Border                   ($25)                                     Macy's            ($25, $100, $500, $1000)
 Claim Jumper                            ($25)                                     Mervyns                              ($25)
 Coco's                                  ($10)                                     Office Depot                         ($25)
 Cold Stone Creamery                      $10)                                     Regal, Edwards, UA Theaters          ($25)
 Denny's                                 ($10)                                     Ross Dress for Less                  ($25)
 EIPolloLocQ                             ($10)                                     Staples                              ($25)
 El Torito/Acapulco                      ($25)                                     T.J. MaxxlMarshall's                 ($25)
 Hometown Buffet                         ($25)                                     Toys & Babies 'R' Us                 ($20)
 Islands                                 ($25)                                     Wal*Mart                       ($25, $100)
 Jack-in-the-Box                         ($15)                                     DRUG STORES
 Jamba Juice                             ($10)                                     CVS Phannacy                         ($25)
 Kentucky Fried Chicken                   ($5)                                     Longs                          ($25, $100)
 ~Aimi' s Cafe                           ($25)                                     Rite Aid                             ($25)
 Olive GardenlRed Lobster                ($25)                                     QM
 Outback Steakhouse                      ($25)                                     Arco                                               ($50)
 P.F. Chang's China Bistro               ($25)                                     Chevron                                            ($50)
 Souplantation                           ($10)                                     ExxonIMobil                                        ($50)
 Starbucks                          ($10, $25)                                     Shell Prepaid Card                                 ($50)
                "accepts payment on account; write the scrip serial number down for reference in case your account is not credited properly
 S~ECIAL    ORDERS                                       AMOUNT                    SPECIAL                                                           AMOUNT
                                                                                   Nazareth Scrip Voucher                  ($5, $10, $25)
                                                                                   Gift Card Folders                               (50¢)
                                                                                                                                               ----

 INSTRUCTIONS .­                                                                                                                                $
- - Please send home with my child.
--     I will pick up in daycare.
                                                                                                FOR OFFICE

                                                                                                USE ONLY

                                                                                                                  I
                                                                                              Form of Payment:              D Cash
--     I will pick up it! the school office.                                                                                D Check No.
                                                                                              Filled by:                    D Nazareth Vouchers
Signature
                                           .Thank you for supporting Nazaretb School!!!

                                             No amount of any payment for gift certificates is deductible
                                             as a charitable contribution for federal income tax purposes.                               5/20/2008
                         Nazareth School Scrip Program

                  SPECIAL ORDER SCRIP VENDORS


Ace Hardware                   ($25)         MARIE CALLENDER'S                ($25)

Amazon. com                    ($25)         The Men's Wearhouse              ($25)

ARBY'S                         ($10)         MICHAELS                         ($25)

BATH & BODY WORKS              ($10)         Motherhood                       ($25)

BED, BATH & BEYOND             ($25)         PAYLESS SHOESOURCE               ($20)

BENNIGANS                      ($25)         Pep Boys                         ($20)

BEST BUY                 ($25, $100)         PetSmart                         ($25)

BIG 5 SPORTING GOODS           ($25)         PICK UP STIX                     ($25)

BLOOMINGDALES            ($25, $100)         Pier 1                       ($25)

BOSTON MARKET                  ($10)         PIZZA HUT                   ($10)

Chevy's                        ($25)         POT. BARNI WILL. SONOMA      ($25)

CHUCK E. CHEESE                ($10)         Radio Shack                  ($25)

Circuit City             ($50, $100)         Restoration Hardware ($25,  $100)

Cracker Barrel                 ($10)         SE~S             ($25, $100,$250)

Crate & Barrel           ($25, $100)         SEE'S CANDY               ($15/1b)

DAVB AND BUSTERS               ($25)         SPORT MARTI SP. AUTH         ($25)

DEL TACO                        ($5)         SUBWAY                       ($10)

Dillard's                ($25, $100)         Sunglass Hut                 ($25)

DISNEY            ($25, $100, $1000)         TALBOT'S                     ($25)

Dominos Pizza                    ($5)        T.G.!. FRIDAY'S              ($25)

Dress Bam                      ($25)         Uno's Pizza                  ($25)

Eddie Bauer                    ($25)         WALGREENS                    ($20)

Express                        ($25)         W'ENDY'S                     ($10)

Footlocker                     ($25)
GNC                            ($25)         TRAVEL

Hard Rock Cafe                 ($25)         American Airlines   ($50, $100, $250)

Hickory Fanns                  ($10)         Best Western Hotels       ($25, $100)

HONEYBAKED HAMS                ($10)         Carnival Cruise                ($100)

JoAnn Fabrics                  ($20)         Hyatt Hotels              ($25, $100)

1 CREW                         ($25)         Marriott                  ($50, $100)

KAYBEE TOYS                    ($10)         Avis Car Rental                 ($50)

Kragen Auto Parts              ($25)         Budget Car Rental               ($50)



The denominations that the Scrip comes in are listed. When ordering, please order
the appropriate amOlll1t based on the denominations. Write your order on the other
side in the _Special Order area. Please allow at least 14 days delivery time for all
Special Orders. Changes to the Special Order form will be in bold print. We have a
limited amount on hand of the stores listed in CAPITAL LETTERS. Thank you for
all your support!

                      SCRIP - IT'S THE ONLY WAY TO BUY!!!             5121/2008

								
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