St Johns Cpt Scrip Gift Card Order Form - St Johns Fox Lake
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1ST. JOHN’S CPT SCRIP Gift Card Order Form
DATE:
Sales of on-hand SCIP cards are Fridays 8-8:30AM and
NAME:
Sundays between services
NO WAITING – PAY & PICK UP SAME DAY – limited quantities
PHONE:
Any other time, please place your order in the
SCRIP mailbox which is mounted on the side of the mailboxes in
fellowship hall.
If you have not completed an Agreement Form, please comply so
that your earnings are credited to the correct account.
EXT
Gift Cards
QTY
REBATE
PRICE
EXT
Gift Cards
QTY
REBATE
PRICE
3%
Amazon $25
10%
Applebee’s $25
8%
Pizza Hut $10
Arby’s $10
8%
8%
Pizza Ranch $25
8%
Rechek’s $25
5%
Auto Zone $25
1.5%
Rechek’s $50
5%
BP $50
1.5%
Rechek’s $100
5%
BP $100
8%
9%
Boston Store/Younkers $25
Red Lobster/Olive Garden $25
8%
2.5%
Boston Store/Younkers $100
Shell Gas $25
5%
2.5%
Chalet (Fox Lake) $25
Shell Gas $50
5%
2.5%
Chalet (Fox Lake) $50
Shell Gas $100
Culver’s $10
8%
3%
Shopko $25
Culver’s $25
8%
3%
Shopko $100
8%
5%
Dominoes $10
Staples $25
12%
6%
Family Video $10
SubWay $10
Feil’s Supper Club $25
10%
5%
Taco Bell $10
Feil’s Supper Club $50
10%
2%
Target $25
5%
NEW
8%
Fleet Farm $25
Texas Roadhouse $25
5%
6%
Fleet Farm $50
Walgreens $25
5%
Walmart/Sam’s Club $25
2.5%
Fleet Farm $100
5%
Walmart/Sam’s $100
iTunes $15
2.5%
6%
Walmart/Sam’s
$250
2.5%
JoAnn Fabrics $25
Jung’s $25
5%
Wendy’s $10
4%
8%
Kentucky Fried Chicken $5
TOTAL COLUMN B
Kohl’s $25*
4%
SPECIAL ORDERS
Kohl’s $100*
4%
Write in cards that you wish to order below.
4%
Kwik Trip $25
Vendor lists available at the SCRIP table. Online orders may
4%
Kwik Trip $50
be placed at Orders are placed on
4%
Kwik Trip $100
Monday and cards are received by Thursday evening.
7%
Maurices $20
5%
McDonalds $10
3%
Menards $25
3%
Menards $100
NEW
8%
Panda Express $25
9%
NEW
Panera Bread $25
Papa Murphy’s $10
8%
4%
Pick & Save $25
4%
Pick & Save $50
TOTAL SPECIAL ORDERS
4%
Pick & Save $100
TOTAL COLUMN A
3%
Piggly Wiggly $25
TOTAL COLUMN B
3%
Piggly Wiggly $50
3%
Piggly Wiggly $100
GRAND TOTAL
TOTAL COLUMN A
Paid ____Cash ____Check #____________
*Kohl’s allows you to pay your store credit card bill with SCRIP
Checks Payable to: ST. JOHN’S CPT SCRIP
For Office Use Only
A $30 fee will be charged for all bad checks
Entered into designated accounts ____________
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