Printable Scrip Order Form - North American Martyrs Catholic Church

North American Martyrs SCRIP
Please do not seal envelope.
Please count your certificates before leaving.
North American Martyrs cannot be responsible for lost or stolen SCRIP.
If possible, please notify in advance for very large orders.
Please make checks payable to: North American Martyrs SCRIP.
Special Order Envelope Requested____
Quantity Vendor % (profit) Value Net $ Culver’s 10% $ 5 Menards 4% $ 25 SuperSaver 3% $ 20
Ace Hardware 4% $ 25 CVS Pharmacy 6% $ 25 O.Gardn/Rd.Lobs9% $ 25 SuperSaver 3% $ 50
Amigos 10% $ 2.50 DQ Grill&Chill 15% $ 5 Panera Bread 9% $ 10 SuperSaver 3% $100
Applebee’s 8% $ 25 Dennis Uniform 5% $ 20 Papa John’s 15% $ 5 Taco Bell 5% $ 10
Arby’s 8% $ 10 Famous Dave’s 10% $ 10 Perkins 20% $ 10 Target 2% $ 25
BNoble/BDalton 9% $ 10 Gloria Deo 5% $ 20 Pizza Hut 8% $ 10 Toast 5% $ 10
Bath & Body 13% $ 10 GodfathersPizza15% $ 5 Raising Cane’s 30% $ 5 ToysRUs 1.5% $ 20
BedBathBeyond 7% $ 25 Gordman’s 7% $ 25 Ruby Tuesday 8% $ 25 U-Stop 5% $ 10
Best Buy 3% $ 25 Home Depot 4% $ 25 Runza 10% $ 10 Valentino’s 10% $ 5
Braeda 10% $ 10 HyVee 3% $ 25 Russ’s 5% $ 50 Walgreens 6% $ 25
Burger King 4% $ 10 HyVee 3% $ 50 Savemart 3% $ 5 WalMart/Sams2.5% $ 25
Cabela’s 11% $ 25 HyVee 3% $100 Savemart 3% $ 10 WalMart/Sams2.5% $100
CarlosO’Kellys 9% $ 10 IGA MarketPlace 5% $ 25 Scheels 5% $ 25 Wendy’s 4% $ 10
Casey’s 3% $ 25 JCPenney 5% $ 25 Shopko 3% $ 25 Scrip Gift Certificate $ 5
Chipotle 10% $ 10 Kohls 4% $ 25 Starbucks 7% $ 10 Scrip Gift Certificate $ 10
Claire’s 9% $ 10 Kohls 4% $100 Subway 3% $ 10
Cracker Barrel 9% $ 10 Marcus Theatre 10% $ 5 SunMart 5% $ 10
*Kohls is the only vendor allowing Scrip payments on a charge account.
Pay in store only. Payment is not accepted through the mail.
* New Vendor or Changes in Current Vendor Sorry, All Sales Final!
Name: ___________________________________________
**Student Name: __________________________ **GRADE:__________
Order Total $_________
Thank You!

Purchase Scrip:
o During all weekend Masses
o At the school during regular office hours (call ahead at 476-7373.)
o At the parish office when school is not in session (call ahead at 476-8088)
o For more information, call Cathy at 474-6143 or Carol at 435-1384
SPECIAL ORDER VENDOR ENVELOPES
ARE AVAILABLE AT THE SCRIP TABLE OR UPON REQUEST.
SEPARATE PAYMENT IS REQUIRED.