Name __________________________________ Date



Trinity Lutheran Church and School

Scrip Cash & Carry Form

Name ___________________________ Date ___________ Phone # ___________ Amount $_________

Payment ______ Check (Make checks payable to Trinity Lutheran Scrip ____ Cash Updated 6/13/17

|LOCAL BUSINESSES |$ |% |Qty |Total |

|Abele’s – in season |$20 |10% | | |

|Bronners |$10, $25 |10% | | |

|Dunn Hardware | $25, $50 |5% | | |

|Fritz’s Family Restaurant |$10 |5% | | |

|Papio’s |$10, $25 and|15% | | |

| |$50 | | | |

|Pompei |$10 |5% | | |

|Rocket Bar & Grill |$10 & $25 |5% | | |

|Trackside |$20 |5% | | |

|Dept. & discount Stores |$ |% |Qty |Total |

|JCPenney Cash Card |$25 |5% | | |

|$100 by order only | | | | |

| | | | | |

| |$100 | | | |

|Kohl’s “Cares for Kids” |$10 |5% | | |

|(Can be used to pay charge balance) | | | | |

| |$25 | | | |

| |$50 | | | |

| | | | | |

| |$25 |2½ | | |

|Target | |% | | |

|Amazon $25 and $100 ( $10 when |$25,$100 |2 ½% | | |

|available) | | | | |

| | | | | |

|Wal-Mart / Sam’s Club | $25, $100 |3% | | |

|( $10 when available) | | | | |

|Meijers ($10 when available,$50 by |$10,$25 |3% | | |

|order only) |&$100 | | | |

A

|Dining – Fine to Fast Food |$ |% |Qty |Total |

|Applebees |$25 |8% | | |

|Arby’s |$10 |8% | | |

|Bob Evans |$10 |10% | | |

|Buffafo Wild Wings $10 by order only |$25 |8% | | |

|Burger King |$10 |4% | | |

|Chili’s / Macaroni Grill / |$25 |11% | | |

|Cracker Barrel |$10,$25 |8% | | |

|Logans Roadhouse |$25 |10% | | |

|Outback / Carrabba’s $50 by order only|$25 |8% | | |

|Panera Bread $25 by order |$10 | 8% | | |

|Pizza Hut | $10 |8% | | |

|Red Lobster / Olive Garden / Bahama |$25 |8% | | |

|Breeze / Smokey Bones | | | | |

|Subway $50 by order |$10 |6% | | |

|Taco Bell |$10 |5% | | |

|Tim Horton/s |$10 |5% | | |

|Wendy’s |$10 |4% | | |

|Electronics & Office |$ |% |Qty |Total |

| |$25 |4% | | |

|Best Buy 100 & 250 by order | | | | |

| | | | | |

| | | | | |

|Gas & Auto |$ |% |Qty |Total |

|Speedway |$25 |4% | | |

|$100 by order only | | | | |

| |$100 | | | |

|Grocery |$ |% |Qty |Total |

|GFS Marketplace |$25 |4% | | |

|$100 cards by order only | | | | |

| |$100 | | | |

| | | | | |

|Home Improvements |$ |% |Qty |Total |

|Home Depot - $100 & |$25 |4% | | |

|$500 cards by order only | | | | |

| | | | | |

|Lowe’s Gift Card - $100, |$25 |4% | | |

|$500 & $1000 by order only | | | | |

| | | | | |

|Menards Home Center | |3% | | |

|$100 & $500 by order only |$25 | | | |

| |$50 | | | |

|CLOTHING/specialty |$ |% |Qty |Total |

| | | | | |

|Barnes & Noble $25 & $100 by order |$5 & $10 |9% | | |

|only ($5 when avail.) | | | | |

|Bath & Body Works |$10,$25 |13% | | |

| | | | | |

|Bed, Bath & Beyond |$25 |7% | | |

|I Tunes-$25 by order only |$15 |5% | | |

|Jo-Ann Fabrics |$25 |6% | | |

|Rite Aid |$25 |4% | | |

|Toys R Us/Babies R Us |$20 |3% | | |

|Sporting Goods |$ |% |Qty |Total |

|Cabelas ($100 by order) |$25 |11% | | |

| | | | | |

|Extra Stuff |$ |% |Qty |Total |

|Cascading Card File |$3 |25% | | |

| | | | | |

|TOTAL THIS PAGE | | | | |

|TOTAL BACK PAGE | | | | |

Retailers on back side of this sheet are available on an

ORDER ONLY basis.

The retailers below are available on an ORDER ONLY basis. For complete list, see red folder, or go to and click on Retailer list.

|ORDER EXTRAS HERE |$ |% |Qty |Total |

|Ace Hardware |$25 |4% | | |

| |$100 | | | |

|Aeropostale |$25 |10% | | |

|American Eagle |$25 |10% | | |

|American Girl |$25,$100|9% | | |

|Avis Car Rental |$50 |8% | | |

|Bass Pro Shops |$25 |9% | | |

| |$100 | | | |

|Best Western International |$25 |12% | | |

| |$100 | | | |

|BP Gas Cards |$50 |1 ½% | | |

|Budget Car Rental |$50 |8% | | |

|Build-A-Bear Workshop |$25 |8% | | |

|Burlington Coat Factory |$25 |8% | | |

|The Children’s Place |$25 |12% | | |

|Chuck E Cheese |$10 |8% | | |

|Claire’s |$10 |9% | | |

|Cold Stone Creamery |$10 |8% | | |

|Comfort Inn / Clarion / |$50 |3% | | |

|Quality Inn / Sleep Inn | | | | |

| |$100 | | | |

|Crate & Barrel – Also $100 |$25 |8% | | |

|CVS Pharmacy |$25 |6% | | |

| | | | | |

|Denny’s Restaurants |$10 |7% | | |

|Dick’s Sporting Goods – Also $100 |$25 |8% | | |

|Domino’s Pizza |$10 |8% | | |

|Dress Barn |$25 |8% | | |

|Dunham Sports |$25 |8% | | |

|Footlocker / Lady FL / Kid’s FL |$25 |8% | | |

|Hallmark |$25 |4% | | |

|Harry & David |$50 |12% | | |

|Jiffy Lube |$30 |8% | | |

|L. L. Bean (can use on-line) |$25 |16% | | |

| |$100 | | | |

|Land’s End (Sears & K-Mart) |$25 |16% | | |

| |$100 | | | |

| |$10 |8% | | |

|Long John Silvers | | | | |

|Macy’s |$25 & |10% | | |

| |$100 | | | |

|Marshall’s |$25,$100|7% | | |

| | | | | |

|Marathan Gas Card |$25, 100|3% | | |

|Michaels |$25 |4% | | |

|Men’s Wearhouse |$25 |8% | | |

|Office Max/Office Depot |$25 |5% | | |

|Old Navy/Gap |$25 |14% | | |

| | | | | |

|Panda Express |$25 |8% | | |

|Payless Shoe Store |$20 |13% | | |

|Peebles |$25 |8% | | |

|Pier 1 Imports |$25 |9% | | |

|Pottery Barn / PBTeen / PBKids |$25 |8% | | |

| |$100 | | | |

|Rainforest Café |$25 |9% | | |

|Ruby Tuesday |$25 |8% | | |

| | | | | |

|Shell Gas $25, $50 & $100 |$25 |2% | | |

|Shoe Carnival |$25 |5% | | |

|Stqples $100 also available |$25 |5% | | |

|Starbucks |$10 & |7% | | |

| |$25 | | | |

| | | | | |

| | | | | |

|T.J.Maxx / Marshalls / HomeGoods / | | | | |

|A.J.Wright | | | | |

| |$100 | | | |

|Uno’s |$25 |12% | | |

|VG’s Grocerries |$25,$100|2% | | |

| | | | | |

|Walgreen’s |$25 |6% | | |

| |$100 | | | |

|Younker’s |$25 |8% | | |

| |$100 | | | |

| | | | | |

|TOTAL THIS PAGE | | | | |

................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download