STOP & SHOP, SHAWS, & DAVE’S GIFT CERTIFICATES
|Name: | |Phone #: | |Email: | |
|Please return the completed form with payment in full to: |NOTE: Cash, Check or Money Orders are acceptable. |
|Temple Sinai |Please make checks payable to: |
|Attn: Gift card Program |Temple Sinai |
| |
|Store Card Denominations Qty $ Amount |
|Dave’s Marketplace |___# of cards @ $25 | ___# of cards @ $50 | ___# of cards @ $100 | | |
|Stop & Shop |___# of cards @ $25 |___# of cards @ $50 |___# of cards @ $100 | | |
|Shaw’s |___# of cards @ $25 |___# of cards @ $50 |___# of cards @ $100 | | |
|Aeropostale |___# of cards @ $25 |___# of cards @ $25 |___# of cards @ $100 | | |
|AMC/Lowes Theaters |___# of cards @ $25 |___# of cards @ $50 |___# of cards @ $100 | | |
|American Eagle |___# of cards @ $25 |___# of cards @ $50 |___# of cards @ $100 | | |
|Applebees |___# of cards @ $25 |___# of cards @ $50 |___# of cards @ $100 | | |
|Babies R Us |___# of cards @ $25 |___# of cards @ $50 |___# of cards @ $100 | | |
|Barnes & Noble |___# of cards @ $25 |___# of cards @ $50 |___# of cards @ $100 | | |
|Bass Pro |___# of cards @ $25 |___# of cards @ $50 |___# of cards @ $100 | | |
|Bath & Body Works |___# of cards @ $25 |___# of cards @ $50 |___# of cards @ $100 | | |
|Bed Bath & Beyond |___# of cards @ $25 |___# of cards @ $50 |___# of cards @ $100 | | |
|Best Buy |___# of cards @ $25 |___# of cards @ $50 |___# of cards @ $100 | | |
|Cabelas |___# of cards @ $15 |___# of cards @ $50 | | | |
|Cheesecake Factory |___# of cards @ $45 | | | | |
|Chili's | |___# of cards @ $50 | | | |
|Coldstone | |___# of cards @ $30 | | | |
|Cracker Barrel |___# of cards @ $25 | | | | |
|Disney |___# of cards @ $25 |___# of cards @ $50 |___# of cards @ $100 | | |
|DSW |___# of cards @ $25 |___# of cards @ $50 | | | |
|Dunkin Donuts |___# of cards @ $15 |___# of cards @ $25 | | | |
|Express |___# of cards @ $15 |___# of cards @ $50 |___# of cards @ $100 | | |
|Forever 21 |___# of cards @ $25 |___# of cards @ $50 | | | |
|Fridays |___# of cards @ $25 |___# of cards @ $50 | | | |
|Gap |___# of cards @ $25 | - | | | |
|Home Depot |___# of cards @ $25 |___# of cards @ $50 |___# of cards @ $100 | | |
|iTunes |___# of cards @ $15 |___# of cards @ $25 |___# of cards @ $50 | | |
|JC Penney |___# of cards @ $25 |___# of cards @ $50 |___# of cards @ $100 | | |
|Justice |___# of cards @ $25 | | | | |
|Kohls |___# of cards @ $25 |___# of cards @ $50 | | | |
|Lowes |___# of cards @ $25 |___# of cards @ $50 |___# of cards @ $100 | | |
|Macy's |___# of cards @ $25 |___# of cards @ $50 |___# of cards @ $100 | | |
|McDonalds |___# of cards @ $15 |___# of cards @ $25 | | | |
|Nike |___# of cards @ $25 |___# of cards @ $50 |___# of cards @ $100 | | |
|Ocean State Job Lot | |___# of cards @ $50 | | | |
|Old Navy |___# of cards @ $25 |___# of cards @ $50 |___# of cards @ $100 | | |
|Olive Garden |___# of cards @ $25 |___# of cards @ $50 |___# of cards @ $100 | | |
|Outback |___# of cards @ $25 |___# of cards @ $50 |___# of cards @ $100 | | |
|Panera |___# of cards @ $25 |___# of cards @ $50 | | | |
|PF Chang's |___# of cards @ $25 |___# of cards @ $50 | | | |
|Pottery Barn | |___# of cards @ $50 | | | |
|Red Lobster |___# of cards @ $25 |___# of cards @ $50 | | | |
|Sears |___# of cards @ $25 |___# of cards @ $50 |___# of cards @ $100 | | |
|Shell | |___# of cards @ $50 | | | |
|Southwest Air or Marriott |___# of cards @ $25 |___# of cards @ $50 |___# of cards @ $100 | | |
|(circle which one) | | | | | |
|Staples |___# of cards @ $25 |___# of cards @ $50 |___# of cards @ $100 | | |
|Starbucks |___# of cards @ $25 |___# of cards @ $50 | | | |
|Subway |___# of cards @ $30 | | | | |
| Sephora |___# of cards @ $25 |___# of cards @ $50 | | | |
|Talbots | |___# of cards @ $50 | | | |
|TGI Friday's |___# of cards @ $25 |___# of cards @ $50 | | | |
|Toys R Us |___# of cards @ $25 | | | | |
| | | | | | |
|Total of Gift Cards Ordered | |
|Total Amount Due |$ |
| Please indicate your choice of pick-up by checking one of the following: |
|I will pick up my cards in the front office. |
| |
|Please send home with my child (name)___________________Teacher and room #_______________ |
| |
|Signed_____________________________________ Date________________________________ |
|______I waive any responsibility of loss or damage. (Must be checked or cards will not be released to the student) |
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