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SCRIP Order Form

This document is a family order form for the Cavalier Band Boosters. It lists a variety of gift cards from retailers in different categories that customers can purchase by May 18. It provides the retailer names, gift card amounts available for each, and the percentage that will go towards the Band Boosters for each card sold. Customers are instructed to make checks payable to the Cavalier Band Boosters and that no late orders will be accepted.
Copyright
© Attribution Non-Commercial (BY-NC)
Available Formats
Download as PDF, TXT or read online on Scribd
0% found this document useful (0 votes)
206 views

SCRIP Order Form

This document is a family order form for the Cavalier Band Boosters. It lists a variety of gift cards from retailers in different categories that customers can purchase by May 18. It provides the retailer names, gift card amounts available for each, and the percentage that will go towards the Band Boosters for each card sold. Customers are instructed to make checks payable to the Cavalier Band Boosters and that no late orders will be accepted.
Copyright
© Attribution Non-Commercial (BY-NC)
Available Formats
Download as PDF, TXT or read online on Scribd
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Family Order Forms

Created: 5/11/2012 6:50:23 AM

Cavalier Band Boosters


Orders and money are due Friday, May 18. No late orders will be taken.

Name Check #

Customer # Order Date

Apparel & Accessories Product


Aeropostale $25 American Eagle Outfitters $25 Brooks Brothers $25 Claire's $10 Dressbarn $25 Eddie Bauer $25 Express $25 Fashion Bug/Lane Bryant $25 Finish Line $25 Foot Locker $25 Gap/Banana Republic/Old Navy Options $25 Gymboree $25 J. Crew $25 Lands' End $25 Limited $25 Men's Wearhouse $25

Sears $25

**6.00%

Dining - Fine Product % QTY


8.00%

% QTY
7.00% 10.00% 16.00% 9.00% 8.00% 10.00% 10.00% 6.00% 10.00% 9.00% 14.00%

Total
$ $ $ $ $ $ $ $ $ $ $

Dining - Casual Product


Applebee's $25 Applebee's $50 bd's Mongolian Grill $20 Bob Evans $10 Boston Market $10 Buffalo Wild Wings $10 Buffalo Wild Wings $25 Cheesecake Factory $25 Chili's $25 Chuck E. Cheese $10

Total
$

% QTY
**10.00 % **10.00 % 8.00% 10.00% 12.00% 8.00% 8.00% 5.00% 11.00% 8.00% 9.00% 9.00% 9.00% 8.00% 8.00% 13.00% 8.00% 8.00% 9.00% **11.00 % 8.00% 8.00% 9.00%

Total
$ $ $ $ $ $ $ $ $ $

P.F. Chang's $25

Dining - On The Go Product


Arby's $10 Burger King $10 Chipotle Mexican Grill $10 Cold Stone Creamery $10 Domino's $10 Fazoli's $25 Great Harvest Bread $10 Jamba Juice $10 KFC $5

% QTY
8.00% 4.00% 10.00% 8.00% 8.00% 7.00% 6.00% 7.00% 8.00% 8.00% **10.00 % **10.00 % 8.00% 8.00% 7.00% 10.00% 7.00% 7.00% 8.00% 3.00% 5.00% 5.00% 4.00%

Total
$ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $

13.00% 13.00% **18.00 % 9.00% 8.00%

$ $ $ $ $ $ $ $ $

Cracker Barrel $10 Cracker Barrel $25 Landry's Restaurants $25 Logan's Roadhouse $25 Noodles & Company $10 O'Charley's $25 Olga's Kitchen $20 Outback $25 Red Lobster/Olive Garden $25 Red Robin $25 Ruby Tuesday's $25 Texas Roadhouse $25 TGI Friday's $25

$ $ $

Little Caesars $20 Panera Bread $10 Panera Bread $25

$ $ $ $ $ $ $ $ $ $ Papa John's Pizza $10 Pizza Hut $10 Qdoba $25 Quiznos $10 Starbucks $10 Starbucks $25 Steak 'n Shake $10 Subway $10 Taco Bell $10 Tim Hortons $10 Wendy's $10

Payless Shoes $20 13.00% Talbots $25 The Children's Place $25 TJ Maxx/Marshalls/Ho meGoods $25 13.00% 12.00% 7.00%

Department Store Product


JCPenney $25 Kohl's $25 Macy's $25

% QTY
5.00% 4.00% 10.00%

Total
$ $ $

Make Checks Payable To:

Cavalier Band Boosters

Total Due All Columns:

**Limited time bonus offer. Participating retailers and products are subject to change without notice.

Family Order Forms

Created: 5/11/2012 6:50:23 AM

Cavalier Band Boosters


Orders and money are due Friday, May 18. No late orders will be taken.

Name Check #

Customer # Order Date

Discount Store Product


Kmart $25 Kmart $50 Target GiftCard $25 Target GiftCard $100 Walmart/Sam's Club $25 Walmart/Sam's Club $100

BP Gas Stations $50

1.50% 1.50% 1.50% 8.00% 3.00% 3.00% 2.50% 2.50% 4.00% 4.00% 1.50%

$ $ $ $ $ $ $ $ $ $ $

Home Improvement Product


Ace Hardware $25 Home Depot $25 Home Depot $100 Lowe's $25 Lowe's $500 Lowe's $100

% QTY
4.00% 4.00% 2.00% 2.00% 2.00% 2.00%

Total
$ $ $ $ $ $

Chevron $50 Exxon/Mobil $50 Jiffy Lube $30 Marathon $25 Marathon $100 Shell $25 Shell $50 Speedway $100 Speedway $25

% QTY
4.00% 4.00% 4.00% 4.00% 4.00% 4.00%

Total
$ $ $ $ $ $

Online & Mail Order Product


Amazon.com $25 Amazon.com $100

Electronics & Office Product


Best Buy $25 GameStop $25 Office Depot $25 Office Max $25 RadioShack $25

% QTY
4.00% 4.00% 7.00% **10.00 % **10.00 % **17.00 % 12.00%

Total
$ $ $ $ $ $ $ $ $

% QTY
3.00% 3.00% 4.00% 5.00% 4.00%

Total
Sunoco $50 $

Grocery
$

Product
$ $ $ Gordon Foods Service Marketplace $25 Gordon Foods Service Marketplace $100 Meijer $25 Meijer $50 Meijer $100 $

% QTY
4.00%

Total
$

Groupon.com $25 iTunes $15 iTunes $25

4.00%

$ L.L.Bean $25

Entertainment Product
AMC Theatres/Loews Cineplex $25 AMC Theatres/Loews Cineplex Single Ticket $9.50 Barnes & Noble $10 Barnes & Noble $25 Dave & Buster's $25

% QTY
**12.00 % 16.00%

Total
$

3.00% 3.00% 3.00%

$ $ $

Nike $25

Omaha Steaks $25 11.00% Zappos.com $25 8.00%

Home Decor Product % QTY


7.00% 8.00% 9.00% 8.00%

Service Total
$ $ $ $

Product
Regis Salons $25

% QTY
8.00%

Total
$

9.00% 9.00% 13.00%

$ $ $

Bed Bath & Beyond $25 Crate & Barrel $25 Pier 1 $25 Pottery Barn / Williams-Sonoma $25 Pottery Barn / Williams-Sonoma $100

Specialty Retailer Product % QTY Total


$ $ $ $

Gas & Auto Product


Advance Auto Parts $25 AutoZone $25

Bath & Body Works 13.00% $10 Bath & Body Works 13.00% $25 Build-A-Bear Workshop $25 CVS/pharmacy $25 8.00% 6.00%

% QTY
7.00% 8.00%

Total
$ $

8.00%

Make Checks Payable To:

Cavalier Band Boosters

Total Due All Columns:

**Limited time bonus offer. Participating retailers and products are subject to change without notice.

Family Order Forms

Created: 5/11/2012 6:50:23 AM

Cavalier Band Boosters


Orders and money are due Friday, May 18. No late orders will be taken.

Name Check #

Customer # Order Date

Family Christian Stores $25 GNC $25 Guitar Center $25 Hallmark $25 Honey Baked Ham $25 Jo Ann Fabrics $25 Michaels $25 PetSmart $25 Rite Aid $25 The Container Store $25 Toys R Us/Babies R Us $20 Walgreens $25

9.00% 8.00% 4.00% **5.00% 12.00% 6.00% 4.00% 4.00% 4.00% 9.00% 1.50% 6.00%

$ $ $ $ $ $ $ $ $ $ $ $

Sporting Goods Product


Bass Pro Shops $25 Cabela's $25 Dick's Sporting Goods $25 Dunham's Sports $25 Gander Mountain $25 MC Sports $25 Sports Authority $25

% QTY
**12.00 % 11.00% 8.00% 8.00% 8.00% 8.00% 8.00%

Total
$ $ $ $ $ $ $

Travel Product
Disney $25

% QTY
2.00%

Total
$

Make Checks Payable To:

Cavalier Band Boosters

Total Due All Columns:

**Limited time bonus offer. Participating retailers and products are subject to change without notice.

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