Scrip Order Form
Good Shepherd Lutheran
form date
Order $$$
Name:______________________
Quantity
Asst.
ACCT # Phone: _____________
e-mail: _____________
10-Jul-10
Quantity VENDOR
Acapulco Real-645
Aeropostale-520
Albertson's-635
Amazon.com-493
Amazon.com-620
Amazon.com-637
AMC-636
American Eagle-305
Amie's Pizza-507
Anderson's-118
Anderson's-119
Anderson's-355
Anderson's-585
Anderson's-445
Anderson's-623
Applebee's-288
Appliance Center-438
Arby's-398
Bar Louie-627
Barnes & Noble/B. Dalt-3
Barry's Bagels-371
Baskin Robbins-204
Bass Pro Shops-556
Bath & Body Works-330
bd's Mongolian Grill-624
Beauty Bar-488
Bebe-595
Bed, Bath & Beyond-343
Beirut Restaurants-532
Belk-652
Best Buy-125
Best Buy-558
Best Buy-559
Best Buy-622
Biaggi's-450
Biggby's-376
Black Pearl-642
Bluflame-509
Bluflame-510
Bob Evans-289
Bombrys-583
BooksAMillion-503
Borders Books-596
Boric's-424
Boston Market-383
BP Gas-472
Bravo's-460
Brieschke's Bakery-590
Build-A-Bear-470
Burger King-12
BW3's-473
Byrne Rd Moto Photo-449
Cabela's-356
Café Marie-416
Caper's Bar-536
Carmel's-400
Cedar Point 1 Day Adm.-511
Charlies Ice Cream/Pizza-483
Cheesecake Factory-653
Children Place-649
Chili's/Mac.-290
Chipotle-589
Chuck E. Cheese-474
Churchill's-415
Ciao's/Real Sea-393
Circle K-529
City Barbeque-508
Claddagh's-476
Claire's/Icing-387
Classic Café-498
Coldstone-499
Costco-535
Costco-570
Costco-626
Country Grains Bakery-408
denom.
$25
$25
$25
$25
$100
$250
$25
$25
$10
$15
$25
$50
$100
$250
$500
$10
$100
$10
$25
$10
$10
$2
$25
$10
$25
$40
$25
$25
$25
$25
$25
$100
$250
$500
$25
$10
$10
$10
$100
$10
$25
$20
$25
$10
$10
$50
$20
$10
$25
$10
$20
$10
$25
$10
$20
$20
$40
$5
$25
$25
$10
$10
$10
$25
$25
$25
$10
$20
$10
$10
$10
$25
$100
$500
$10
%
8%
3%
4%
4%
4%
4%
4%
3%
8%
4%
4%
4%
4%
4%
4%
8%
2%
4%
4%
8%
8%
9%
9%
9%
9%
6%
3%
4%
8%
2%
2%
2%
2%
2%
7%
10%
15%
2%
2%
10%
13%
6%
4%
8%
12%
2%
12%
8%
8%
4%
16%
22%
5%
8%
8%
9%
5%
13%
2%
12%
7%
3%
8%
4%
12%
2%
12%
10%
9%
10%
8%
1%
1%
1%
11%
Total $
Quantity VENDOR
Cousino's/Tango's-367
Cracker Barrel-19
CVS-340
CVS-634
Dale's Bar-410
Dave & Buster-650
Del Taco-538
Denny's-441
Dick's Sports-345
Dillard's-286
Dillard's-477
Dinners by Design-522
Disney-527
Disney-609
Disney-545
Disney-546
Don Pablo's-299
Donatos Pizza-617
DOTS-651
DSW-641
Eddie Bauer-25
El Camino Real-413
Elder-Beerman-372
Elephant Bar-492
Executive Diner-598
Express/Structure-293
Expresso Car Wash-399
Family Christian-524
Family Video-392
Famous Dave's-513
Fashion Bug/Lane Bryant/Catherines-615
Fat Fish/Funny Bone-571
Foodtown (Central)-433
Foodtown (Central)-459
Footlocker-26
Forever 21-643
Fresh Market, The-576
Fricker's-405
Friendly's-475
GameStop-605
Gander Mountain-505
Gap-103
Giant Eagle-418
Giant Eagle-454
Original Gino's-363
Gordon's-369
Gordon's-431
Granite City Brewery-594
Ground Round-403
H&M-640
Handel's-521
Home Depot-297
Home Depot-298
Home Depot-547
Home Depot-548
Home Slice Pizza-540
Honey Baked Ham-31
House of Meats-463
Hyatt Hotels-236
Hy-Vee Super-638
Hy-Vee Super-639
Ideal Hot Dogs-411
iHop-606
iTunes-502
J C Penney-328
J C Penney-329
Jing Chuan-504
JJILL-563
Joanne Fabrics-315
Johnny Rockets-447
Kmart/Sears-38
Kazmaier's-417
Kent. Fried Chicken-40
Kohl's-331
Kohl's-489
Date:_____________
"@"__________________
denom.
$25
$10
$25
$100
$10
$25
$10
$10
$25
$25
$100
$50
$25
$100
$500
$1,000
$25
$10
$25
$25
$25
$20
$25
$20
$20
$25
$5
$25
$10
$10
$25
$20
$25
$100
$25
$25
$25
$10
$10
$25
$25
$25
$25
$100
$10
$25
$100
$25
$10
$25
$10
$25
$100
$500
$1,000
$10
$10
$10
$25
$25
$100
$5
$25
$15
$25
$100
$20
$25
$20
$10
$25
$50
$5
$25
$100
%
Total $
11%
9%
4%
4%
12%
2%
6%
7%
8%
9%
9%
5%
2%
2%
2%
2%
8%
10%
2%
2%
9%
11%
8%
10%
11%
8%
8%
8%
13%
6%
6%
11%
4%
4%
2%
2%
7%
11%
8%
3%
9%
9%
4%
4%
13%
3%
3%
11%
17%
2%
8%
2%
2%
2%
2%
8%
12%
2%
9%
4%
4%
8%
3%
3%
4%
4%
8%
9%
4%
12%
4%
4%
9%
4%
4%
Scrip Order Form
Good Shepherd Lutheran
Kroger-485
Kroger-486
Lady C Clothier-530
Lambertville Foodtown-629
Lambertville Foodtown-630
Land's End-409
Land's End-569
Land's End-549
Learning Express-501
Legacy Golf-465
Levis Commons $25 Gift Card-601
Libbey Glass-446
Limited/Too-159
Little Caesar's-534
LL Bean-469
Loma Linda's/Ventura's-377
Long John Silver's-395
Lowe's-321
Lowe's-322
Lowe's-550
Lowe's-551
Macy's-379
Magic Wok-420
Mancino's-543
Mancy's/Shorty's-458
Marco's-401
Marriott-241
Marriott-531
Marriott-552
Max & Erma's-300
McDonald's®-584
McDonald's®-364
Meijer's-588
Meijer's-55
Melting Pot-568
Menard's-462
Menard's-566
Michael's-575
Monnette's-471
Mytee Auto-516
Mytee Auto-517
Not Just Cookies-591
Office Depot-523
Office Max-68
Old Navy/Tri Card-70
Olga's Kitchen-614
Outback/Carraba's-320
PACSUN-654
Panera's-373
Papa John's-506
Pasta Fina-539
Payless Shoes-295
Penn Station Subs-481
Perry Falls MiniGolf-480
Pet Smart-567
Petco-448
PF Chang's-526
Pier One-78
Pizza Hut-79
PlayStation-612
Pottery Barn-456
Publix-582
Quiznos-464
Ralphie/Big Boy/Holiday Inn-374
RAVE Movie Ticket-361
Red Lobster/Olive Garden-81
Red Robin-227
Reger's-396
Reve-542
Rite Aid-382
Rosie's-388
$25
$100
$25
$25
$100
$25
$100
$500
$25
$50
$30
$20
$25
$10
$25
$10
$5
$25
$100
$500
$1,000
$25
$10
$10
$25
$10
$25
$100
$500
$10
$15
$25
$25
$100
$25
$20
$100
$25
$10
$20
$100
$10
$25
$25
$25
$20
$25
$25
$10
$20
$25
$10
$10
$6
$25
$25
$25
$25
$20
$20
$25
$50
$10
$20
$10
$25
$10
$10
$50
$25
$20
1%
1%
8%
4%
4%
14%
14%
14%
2%
8%
12%
12%
2%
8%
13%
11%
8%
4%
4%
4%
4%
10%
8%
8%
7%
18%
9%
9%
9%
13%
1%
1%
2%
2%
18%
3%
3%
3%
4%
4%
4%
9%
3%
3%
9%
9%
9%
2%
9%
6%
8%
3%
8%
15%
2%
5%
8%
6%
8%
3%
6%
2%
10%
12%
15%
9%
9%
8%
18%
4%
8%
Name:______________________
Ruby Tuesday's-83
Russ' Car Wash-378
Russ' Car Wash-497
Sakura's-619
Sally Beauty Supply-597
Salsarita's Fresh Cantina-577
Sautter's-500
Sautter's-555
Schlotzky's Deli-436
Sears/Kmart-88
Sephora-533
Service Master-432
Shell Gas-243
Shell Gas-592
Shoe Carnival-425
Shutterfly-525
Sidelines-461
Sofo's-389
Sonic-628
South Toledo Golf Green's fee-366
Spaghetti Warehouse-426
Speedway-326
Speedway-453
Speedway-368
Speedway-419
Staples-604
Starbuck's-358
Steak 'n Shake-578
Steinmart-386
Subway-394
Super Supper-541
T. J. Maxx/Marshalls-325
Talbot's-484
Target-579
Target-580
Target-608
Temperance Foodtown-631
Temperance Foodtown-632
Texas Roadhouse-479
TGI Fridays-231
TicketMaster-518
TicketMaster-519
Tim Horton's-323
Tony Packo's-439
Touch of Class Dry Cleaners-391
Toys-R-Us/Baby's-587
Toys-R-Us/Baby's-106
Toys-R-Us/Baby's-633
Twin Oak's Cleaners-414
Ulta Salons-593
Universal Studio-655
Universal Studio-656
Vito's Pizza-607
Wal*Mart-572
Wal*Mart-560
Wal*Mart-561
Wal*Mart-573
Wal*Mart-625
Walgreen's-442
Walt Churchill's Mark-482
Walt Churchill's Mark-618
WeeWorld-616
Wendy's-233
Westfield/Franklin Park Mall $25 Card-599
Whole Foods Market-644
Wii 2000 points-610
Winn-Dixie-581
Wixey Bakery-412
Xbox 1600pts-611
Xbox Live 3 GOLD Month-613
$25
$7
$12
$25
$25
$10
$25
$100
$5
$25
$25
$100
$25
$50
$25
$25
$10
$10
$10
$25
$10
$10
$25
$50
$100
$25
$10
$10
$20
$10
$25
$25
$25
$25
$50
$100
$25
$100
$25
$10
$25
$100
$10
$25
$10
$15
$25
$100
$10
$25
$25
$100
$10
$10
$25
$100
$250
$500
$25
$25
$100
$20
$10
$30
$25
$20
$50
$5
$20
$25
8%
10%
7%
13%
11%
7%
4%
4%
7%
4%
4%
2%
2%
2%
5%
9%
12%
8%
5%
20%
18%
4%
4%
4%
4%
3%
7%
8%
4%
4%
8%
7%
5%
1%
1%
1%
4%
4%
9%
9%
4%
4%
3%
14%
8%
2%
2%
2%
8%
4%
2%
2%
18%
2%
2%
2%
2%
2%
2%
2%
2%
3%
4%
10%
2%
3%
2%
8%
3%
3%