NOTRE DAME SCRIP ORDER FORM
Family Name:								Phone #:			Date:
Check #:		Amount: $		(Circle One)				Pick Up   or    Send	Home	Name/Grade:
1.  Cash or Check Payable to Notre Dame Scrip (notredame-pa.org)								2.  Orders due Mondays by 9:00 a.m.			3. Delivery will be on Thursdays
NOT RESPONSIBLE FOR LOST CARDS AFTER PURCHASE OR DELIVERY TO CHILD.
RETAILER	%	QTY	$	TOTAL				RETAILER	%	QTY	$	TOTAL
Amazon.com	4%		$25					JCPenney	5%		$25
			$100								$100
American Eagle	8%		$25					JoAnn Fabrics	6%		$20
Applebee's	8%		$25					KFC	9%		$5
Arby's	8%		$10					Kmart	4%		$25
Art and Frame Gallery	6%		$25								$50
Auntie Ann's Pretzels	8%		$10					Kohl's	3%		$25
Barnes & Noble	9%		$10								$100
			$25					Kraynak's	2%		$10
			$100					Land's End	9%		$25
Bath & Body Works	13%		$10					Long John Silver	8%		$5
			$25					Lowe's Home Improvement	4%		$25
Best Buy	2%		$25								$100
			$100								$500
Bob Evans	10%		$10					Macy's	7%		$25
Borders	8%		$10								$100
			$25					Marriott Hotels	8%		$50
BP Gas	2%		$50								$100
			$100					Master Cut/Regis	8%		$25
			$250					Outback Steakhouse	4%		$25
Burger King	4%		$10					Panera Bread*	7%		$10
The Bicycle Store	7%		$25					Payless Shoes	13%		$20
			$100					Pizza Hut	8%		$10
Cabela's	9%		$25					Philadelphia Candies	8%		$10
			$100					Pottery Barn/Wm.Sonoma	8%		$25
Chuck E. Cheese	8%		$10								$100
Claire's Boutique	9%		$10					Quaker Steak & Lube	7%		$10
Cottage Gardens	5%		$10					Red Lobster/Olive Garden	9%		$25
			$25					Rite Aid Pharmacy	4%		$25
			$100					Sears	4%		$25
Dairy Queen-Hermitage	20%		$5								$100
D'Onofrio's*	4%		$10								$250
			$25					Sheetz	3%		$25
			$50								$100
			$100					Shell	1.5%		$25
Denny's	7%		$10								$100
Dick's Sporting Goods	5%		$25					Speedway	4%		$25
Dunham's Sports	8%		$25								$100
Dunkin Donuts	4%		$10					Springfield Group*	7%		$25
Eat N Park	10%		$10					Staples	5%		$25
			$25								$100
GameStop	3%		$25					Starbucks Coffee	7%		$10
Gander Mountain	8%		$25								$25
Gap/Old Navy	9%		$25					Subway	3%		$10
Giant Eagle*	4%		$10								$50
			$25					Sunoco	1.5%		$50
			$50					TJ Maxx/Marshall's	7%		$25
			$100								$100
Great Clips	8%		$25					Walgreens	2%		$25
GNC	8%		$25								$100
Hollywood Video	10%		$10					Walmart	2%		$25
Home Depot	3%		$25								$100
			$100								$250
			$500					Wendy's	4%		$10
								Order Total				$_____________
Inventory available:School Office 8-2:30 M-F, All Weekend Masses  For additional vendors see Great Lakes Scrip www.glscrip.com (*available for immediate purchase)