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St. Therese Parish |
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Revised: 11/26/2007 |
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Scrip Order Form |
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Make checks payable to St. Therese Scrip. Credit Cards (Visa/Mastercard)
also accepted. |
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Order Total |
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Name: |
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Phone: |
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Hold for pick up |
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$ |
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Send home with my child (name): |
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Class: |
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Apparel & Accessories |
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Discount Store |
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Product |
% |
Qty |
Total |
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Product |
% |
Qty |
Total |
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American Eagle Outfitters $25 |
9.00% |
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$ |
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Kmart $25/$50 |
4.00% |
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$ |
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Brooks Brothers $25 |
16.00% |
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$ |
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Walmart $25/$100 |
2.00% |
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$ |
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Claire's $10 |
9.00% |
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$ |
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TJ Maxx/Marshall's $25 |
7.00% |
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$ |
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Dennis Uniforms $20 |
5.00% |
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$ |
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Electronics & Office |
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Eddie Bauer $25 |
14.00% |
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$ |
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Product |
% |
Qty |
Total |
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Express $25 |
13.00% |
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$ |
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Best Buy $25 |
2.00% |
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$ |
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Gap/Banana/Old Navy $25 |
9.00% |
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$ |
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BEST BUY $100 |
2.00% |
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$ |
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Gymboree $25 |
13.00% |
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$ |
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Circuit City $100 |
3.00% |
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$ |
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Lands' End $25 |
9.00% |
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$ |
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Office Depot $25 |
4.00% |
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$ |
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Limited $25 |
9.00% |
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$ |
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Office Max $25 |
5.00% |
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$ |
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Maurices $20 |
7.00% |
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$ |
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RadioShack $25 |
4.00% |
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$ |
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Men's Wearhouse $25 |
8.00% |
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$ |
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Entertainment |
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Payless Shoes $20 |
13.00% |
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$ |
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Product |
% |
Qty |
Total |
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Talbots $25 |
11.00% |
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$ |
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AMC Theaters/Loew's Cineplex $25 |
7.00% |
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$ |
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The Children's Place $25 |
12.00% |
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$ |
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Barnes & Noble/B.Dalton $10 |
9.00% |
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$ |
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Department Store |
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Barnes & Noble/B.Dalton $25 |
9.00% |
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$ |
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Product |
% |
Qty |
Total |
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Barnes &Noble "Teacher Gift" Card $20 |
9.00% |
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$ |
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Dillard's $25 |
9.00% |
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$ |
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Blockbuster $10 |
7.00% |
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$ |
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JCPenney $25 |
5.00% |
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$ |
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Blockbuster Night Card $12.00 |
15.00% |
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$ |
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JCPenney $100 |
5.00% |
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$ |
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