SCRIP Order Form

                                                   Cincinnati Christian Schools Scrip Order Form                                         

Family Name:________________________________    Date:________________            Pickup Campus:   FF / IS

Phone:________________________   Check #: _____________        Order Total: ____________________

STUDENT Name: __________________________Teacher (Elementary only)  __________________                         

    

Retailer

$
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Cost

 

Retailer

$

Credit

Qty

Cost
GROCERY

 

      

 

 

 

 Dream Dinners

$75

8%

 

 
D & W Fresh Market

$25

3%

 

 

 

 BUFFALO WILD WINGS

$10

8%

 

 

$100

3%

 

 

 

$25

8%

 

 
GNC Stores

$25

8%

 

 

 

 CICI’S PIZZA (All-u-eat

$6.25

8%

 

 
Gordon Food Service

$25

4%

 

 

 

       buffet + drink)

 

 

 

 
HONEY BAKED HAM

$10.25

12%

 

 

 

 FRISCH’S

$5

2%

 

 
JUNGLE JIM’S

$10

3%

 

 

 

 GOLD STAR CHILI

$5

6%

 

 

$20

3%

 

 

 

 Golden Corral

$25

3%

 

 
Winn Dixie

$25

4%

 

 

 

 IZZY’S

$5

12%

 

 

$100

4%

 

 

 

 Ky. Fried Chicken

$5

9%

 

 
GAS/CAR

 

 

 

 

 

 Max & Erma’s

$20

13%

 

 
Advance Auto Parts

$25

7%

 

 

 MONTGOMERY INN

$25

7%

 

 
BP

$50

2%

 

 

 

 O’Charley’s

$25

13%

 

 
Exxon/Mobil

$50

1.5%

 

 

 

 Old Country Buffet

$25

5%

 

 
JOHNNY’S CAR WASH

 

 

 

 

 

 Oliv Grdn/Red Lbstr/Smokey Bones BBQ

$25

9%

 

 
   Single, Full Serve

$12.20

20%

 

 

 

 Panera Bread

$10

9%

 

 
   Book of 5 washes

$48.80

5%

 

 

 

 Papa John’s Pizza

$10

8%

 

 
Marathon

$25

3%

 

 

 

 Pizza Hut

$10

9%

 

 

$100

3%

 

 

 

 Red Robin

$10

9%

 

 
MIKE’S CAR WASH

$8

10%

 

 

 

 Ruby Tuesday

$25

8%

 

 
Speedway Car Wash

$6

40%

 

 

 

 Starbuck’s

$10

7%

 

 
Speedway

$25

4%

 

 

 

$25

7%

 

 

$100

4%

 

 

 

 TCBY

$5

10%

 

 
Shell

$25

1.5%

 

 

 

 TGI Friday’s

$20

8%

 

 

$100

1.5%

 

 

 

 Wendy’s

$10

4%

 

 
Sunoco

$50

1.5%

 

 

 
WHITE HOUSE INN

$25

8%

 

 
DINING

 

 

 

 

 
ENTERTAINMENT

 

 

 

 
AGLAMESIS BROS.

$5

5%

 

 

 
AMC Theatres

$25

7%

 

 
Applebee’s

$25

8%

 

 

 
AMC Single Ticket

$9.50

16%

 

 
Arby’s

$10

10%

 

 

 

 Blockbust Sngl Vid

$3.79

15%

 

 
Bob Evans

$10

10%

 

 

 

 Blockbust Sngl Game

$6

15%

 

 
BON BONERIE

$10

5%

 

 

 

 Blockbust Night

$12

15%

 

 
Boston Market

$10

12%

 

 

 
Cinemark Theatres

$25

4%

 

 
Burger King

$10

4%

 

 

 
CONEY ISLAND

$19.50

10%

 

 
BUSKEN BAKERY

$10

6%

 

 

 
Dave & Buster’s

$25

13%

 

 
Cheesecake Factory

$25

5%

 

 

 

 f.y.e. (Suncoast Video)

$25

6%

 

 
Chili’s (CHANGE)

$25

11%

 

 

 

 Game Stop

$25

3%

 

 
Chipotle’s Mex. Grill

$10

10%

 

 

 

 iTunes

$15

4%

 

 
Cold Stone Creamery

$10

8%

 

 

 

 Napster 15 song download

$15

7%

 

 
Cracker Barrel

$10

9%

 

 

 

 NEWPORT AQUARIUM

 

 

 

 
Dominos

$5

5%

 

 

 

      Adult Single Admission

$19.95

9%

 

 
Dominos Combo

$14

25%

 

 

 
    Child Single Admission

$10.95

9%

 

 
Don Pablo’s

$25

8%

 

 

 

 Regal Entertainment

$25

8%

 

 
Donato’s

$10

10%

 

 

 

 Showcase (Nat’l Amusement)

$25

9%

 

 

Retailer

$

Credit

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Cost

 
Retailer

$

Credit

Qty

Cost
RETAIL STORES

 

 

 

 

 

 Steve & Barry’s

$25

6%

 

 

 

 

 

 

 

 T.J. Maxx

$10

7%

 

 
Bass Pro Shop

$25

7%

 

 

 

 Talbot’s

$25

11%

 

 
Barnes & Noble

$10

9%

 

 

 

 Toys/Kids-R-Us

$20

1.5%

 

 

$25

9%

 

 

 

 Value City (not Furn Store)

$10

9%

 

 
Bath & Body Works

$10

13%

 

 

 

 Walgreen’s

$20

2%

 

 

$25

13%

 

 

 

 

 

 

 
Bed Bath & Beyond

$25

7%

 

 

 
TRAVEL

 

 

 

 
Best Buy

$25

2%

 

 

 

 American Airlines

$100

8%

 

 

$100

2%

 

 

 

$250

8%

 

 
Bloomingdale’s

$25

12%

 

 

 

 Avis Car Rental

$50

8%

 

 
Border’s/Walden’s

$10

9%

 

 

 

 BedandBreakfast.com

$50

10%

 

 
Build-A-Bear Wkshp

$25

8%

 

 

 

 Budget Car Rental

%50

8%

 

 
Claire’s

$10

9%

 

 

 

 Comfort Inn

$25

4%

 

 
Crate & Barrel

$25

8%

 

 

 

 Carnival Cruises

$100

8%

 

 

$100

8%

 

 

 

 Disney Gift Card

$25

2%

 

 
CVS

$25

2%

 

 

 

$100

2%

 

 
Dick’s Sporting Goods

$25

5%

 

 

 

 Hyatt Hotels

$25

9%

 

 
Dillard’s

$25

9%

 

 

 
Marus Resorts

$10

5%

 

 
DSW Shoe Warehouse

$25

9%

 

 

 

 Marriott

$50

12%

 

 
Family Christian Store (DENOM. CHANGE)

$25

9%

 

 

 

$100

12%

 

 
Footlocker

$25

9%

 

 

 

 Ritz-Carlton Hotel

$50

12%

 

 
Finish Line

$25

10%

 

 

 

 

 

 
Gap/OldNavy/Ban.Repub

$25

9%

 

 

 
OTHER ORDERS

 

 

 

 
Gymboree

$25

13%

 

 

 

 

 

 

 
Home Depot

$25

3%

 

 

 

 

 

 

 

$100

3%

 

 

 

 

 

 

 
JC Penney

$25

5%

 

 

 

 

 

 

 
Jo Ann Fabrics

$20

6%

 

 

 

 

 

 

 
K Mart

$25

4%

 

 

 

 

 

 

 
Kohl’s

$25

4%

 

 

 

 

 

 

 

$100

4%

 

 

 

 

 

 

 
Linens n’ Things

$25

8%

 

 

 

 

 

 

 
L.L. Bean

$25

15%

 

 

 

 

 

 

 
Land’s End

$25

9%

 

 

 

 

 

 

 
Lowe’s Home Imp.

$25

4%

 

 

 

 

 

 

 

$100

4%

 

 

 

 

 

 

 
Macy’s

$25

9%

 

 

 

 

 

 

 
Men’s Wearhouse

$25

8%

 

 

 

 

 

 

 
NEW BALANCE (in       

$10

8%

 

 

 

 

 

 

 
    Glendale)

$25

8%

 

 

 

 

 

 

 
Office Depot

$25

4%

 

 

 

 

 

 

 
Payless Shoes

$20

13%

 

 

 

 

 

 

 
Regis Salons

$25

8%

 

 

 

 

 

 

 
Sears          

$25

4%

 

 

 

 

 

 

 
Showcase Cinemas

$25

9%

 

 

 

 

 

 

 
Staples 

$25

5%

 

 

 

 

 

 

 

FOR COMPLETE RETAILER LISTINGS AND RESTRICTIONS, VISIT:

http://www.shopwithscrip.com/    and    http://www.appleseed123.com/

Rev. 10-8-07