ST. ATHANASIUS SCRIP ORDER FORM
Name:
Address:
Phone:
Credit applied to:
* We can order these items; however, do not stock them.
GROCERY/GAS
Casey's General Store
(expires)
Fareway (any location)
(expires)
Flying J
Gilbertville Locker
HyVee
Jesup Food Center
Kwik Star
Kwik Star Ultimate Car Wash - 5 washes
Road Ranger
DINING/RESTAURANTS
Applebee's (Now)
Arby's
Barmuda/Becks/Bourbon Street
Bill's Pizza
Brown Bottle-Waterloo only/see Doughy Joey's
Bucketz Bar & Grill
Buffalo Wild Wings (Now/Reload)
Burger King (Now/Reload)
Carlos O'Kelley's
Chili's/Macaroni Grill (Now)
Chuck E. Cheese
Cold Stone Creamery (Now)
Cracker Barrel (Now)
CU Restaurant
Culver's
Dairy Queen
*Dominoe's Pizza (Now/Reload)
Doughy Joey's/Brown Bottle (Waterloo only)
Famous Dave's
*Fazoli
Hardees
Hickory House
Huhot
Ihop (Now)
Junie's
Kentucky Fried Chicken
Knight's of Columbus (Waterloo only)
Legacy
Little Ceasar
LJ's Neighborhood Restaurant
%
3
3
3
3
3
3
3
2
2
5
5
3
3
3
3
3
3
5
5
5
5
5
5
5
5
30
3
3
$
$10
$25
$50
$25
$50
$100
$200
$25
$100
$20
$50
$25
$100
$1
$5
$10
$50
$5
$10
$20
$25
$50
$100
$200
$500
$30
$25
$50
8
8
8
10
10
10
$10
$25
$10
$10
$10
$25
10
10
8
8
4
5
11
8
8
9
10
5
3
8
5
10
7
5
10
10
10
8
5
8
5
10
10
8
8
$10
$25
$10
$25
$10
$25
$25
$10
$10
$10
$25
$10
$10
$10
$20
$10
$25
$10
$25
$10
$25
$25
$5
$5
$5
$10
$25
$20
$10
Qty Total $
DINING/RESTAURANTS Continued
Lone Star Steakhouse
Long Horn Steakhouse - Please see Olive Garden
Long John Silver's
Macaroni Grill - Please see Chili's
*Mama Nick's
McDonalds
Noodles & Co.
Old Chicago
Olive Garden/Red Lobster/Long Horn (Now)
*Omaha Steak (Now)
Other Place (Cedar Falls/Waterloo/Evansdale)
Outback Steakhouse (Now)
Panara Bread (Now)
Panda Express
Papa John Pizza
Papa Murphy's Pizza
Perkins
Pizza Hut (Now)
Pizza Ranch Only (gift card)
*Quiznos
Red Lobster - Please see Olive Garden
*Red Robin (Now only)
Ruby Tuesday
*Rudy's Tacos
Screaming Eagle
Southtown
Starbucks (Now/Reload)
Steamboat Gardens
Subway (Now)
Taco Bell
Texas Roadhouse (Now)
TGI Fridays (Now)
Tokyo
Tony's
Village Inn
Wendy's
Wishbone
GENERAL MERCHANDISE
*Advanced Auto Parts
Aeropostale (Now)
Amazon (Now)
American Eagle (Now)
*Auto Zone
Barnes & Noble/B. Dalton Books (Now)
Bass Pro Shop (Now)
Bath & Body Works (Now/Reload)
Bed, Bath & Beyoond
Best Buy (Now)
Blain's Farm & Fleet
Buckle (Now)
Cabella's (Now)
Cedar Falls Theater - see Marcus Theater
Claire's/Icing
Crossroad's Theater - see Marcus Theater
CVS (Now/Reload)
Cy & Charlie's - tell the store
Dick's Sporting Goods
Dillard's
Discover Gift Card
Dress Barn
Ebay (Now only)
Express (Now)
Family Christian Store
Farmer's Wife
%
10
$
$10
8
$10
8
7
8
6
9
9
11
10
8
9
9
8
8
8
10
8
10
10
$10
$10
$10
$25
$10
$25
$25
$5
$25
$10
$25
$25
$10
$10
$15
$10
$25
$10
9
8
10
5
5
7
7
10
6
5
8
9
10
10
7
13
4
5
$25
$5
$25
$5
$10
$25
$5
$10
$10
$25
$25
$25
$10
$10
$25
$10
$10
7
10
3
3
10
9
9
9
9
13
7
3
3
5
8
11
$25
$25
$25
$100
$25
$25
$10
$25
$25
$10
$25
$25
$100
$25
$25
$25
9
$10
6
2
8
9
1.25
8
7
10
9
20
$25
$25
$25
$100
$25
$25
$25
$25
Qty Total $
GENERAL MERCHANDISE Continued
Finish Line
*Footlocker
*Gamestop (Now)
Gap/Baby Gap - Please see Old Navy
*GNC
Gordmans
Great Clips
Groupon.com (Now)
Hallmark (Reload)
Home Depot
Icing - Please see Claire's
iTunes (Now)
JC Penney - Please see Penney's
Jesup Spahn & Rose - see Dave Sabers
Jiffy Lube (Now/Reload)
Joann Fabrics
*Journey's
Kmart - Please see Sears
Kohl's - can apply to credit card (Now)
Lattin Photography
Lowe's (Now/Reload)
Marcus Theaters(Crossroads/College Square gift card)
Ticket (does not cover 3D & Saturday evening fees)
*Master Cuts
Maurice's
Menard's
Michaels Craft Store
Old Navy/Gap (Now/Reload)
Oriental Trading
Payless Shoes
Penney's (Now/Reload)
Petco (Now)
Pet Smart
*Pier 1 Imports
*Planet X - see Game Stop (Now)
Primitive Peddler
Rose of Sharon Floral & Gift ( contact Sharon Even)
*Sally's Beauty
%
10
9
3
$
$25
$25
$25
8
7
8
7
4
4
4
$25
$25
$25
$25
$25
$25
$100
5
5
$15
$25
8
6
10
$30
$25
$25
5
5
5
5
6
6
6
4
4
9
9
15
8
7
4
4
4
4
4
14
9
13
5
5
4
9
$10
$25
$50
$100
$10
$20
$50
$25
$100
$10
$25
$6.50
$25
$20
$10
$25
$50
$100
$25
$25
$25
$20
$25
$10
$25
$25
10
5
12
$25
Qty Total $ GENERAL MERCHANDISE Continued
Scheel's
SCRIP gift Card
Sears/Kmart (Now)
*Shoe Carnival
*Shopko
Shutterfly (Now)
Staples
*Tanger Outlet
Target (Now/Reload)
TJ Maxx/Marshalls (Now)
*Toys R Us/Kids R Us (Now/Reload)
UnderArmour (Now)
Walgreen's
Wal-Mart (Now)
Waterfalls Car Wash - Regular wash
- Super wash
- Deluxe wash
Younkers (Now)
TRAVEL/MISCELLANEOUS
*American Airlines
*Avis Car Rental
Best Western
*Budget Car Rental
*Carnival Cruise Lines (Now)
*Clarion Hotel
*Comfort Inn Suites
*Dell Computer (Now)
*Disney
*Econo Lodge
*Fairmont Holtel
*Family Video
*Hyatt, etc. (Now/Reload)
Marriott
Phone Card (120 min.)
*Quality Inn Suites
*Ritz-Carlton Hotels
SCRIP card Holder
*Sleep Inn
*Six Flags (1day pass)
%
5
5
0
4
5
3
9
5
8
2.5
2.5
2.5
7
3
11
6
2.5
2.5
2.5
2.5
2.5
13
17
18
8
$
$10
$25
Qty Total $
8
8
12
12
8
8
3
4
4
2
3
9
12
9
8
22
4
12
25
3
8
$100
$50
$25
$100
$50
$100
$50
$25
$100
$25
$50
$25
$10
$25
$50
$8
$25
$50
$3
$50
$25
$25
$25
$25
$25
$25
$10
$25
$100
$25
$20
$25
$25
$10
$20
$25
$50
$100
$11
$14
$16
$25
$
44.25
$25
Most Scrip orders can be filled at the time the order is placed. From time-to-time our inventory does not allow us to complete an order. In the event that this
happens, we will complete your order as soon as possible.
*We do not keep these items in stock, but these items can be ordered and will usually be here in about a week.
You may also set up your own account and order scrip through the Great Lakes Scrip Center. Go to www.GLSCRIP.com for the national list of available
SCRIP that can be ordered. Orders can be placed online at www.shopwithscrip.com.
Questions and comments can be directed to Donna Delagardelle at 827-1609 or 319-239-9945
As always, thank you so much for your order and support of the children at St. Athanasius. We are truly grateful.
Please make checks payable to St. Athanasius Scrip
Check No.
Check Amount
Cash
revised 12/11/15
Staff Initials
Date Completed
Date of Deposit