| Together we are better consumers for St. Agatha School | ||||||||
| Name_________________________________________ | Email Address__________________________________ | |||||||
| Phone #_______________________________________ | ||||||||
| Merchant | Amount | % SA retains | Quantity | Merchant | Amount | % SA retains | Quantity | |
| Retail Stores | Retail Stores | |||||||
| ACE Hardware (Freeburg) | $25/$100 | 4% | Kohl's | $25/$100 | 4% | |||
| Amazon.com | $25/$100 | 4% | L.L. Bean | $25 | 15% | |||
| American Eagle Outfitters | $25 | 9% | Lane Bryant | $25 | 6% | |||
| AT&T 125 minute card | $9.50 | 20% | Lands' End | $25 | 16% | |||
| Barnes & Noble (B. Dalton) | $10/$25/$100 $20 Teacher Card | 9% | Limited | $25 | 9% | |||
| Babies-R-Us/Toys-R-Us/ Kids-R-Us | $20 | 1.5% | Lowe's Home Improvement | $25/$100/$500/ $1000 | 4% | |||
| Bass Pro Shops | $25/$100 | 8% | MACY'S | $25/$100 | 10% | |||
| Bath & Body Works/White Barn Candle Company | $10/$25 | 13% | Marshalls (TJ Maxx) | $25/$100 | 7% | |||
| Bed Bath & Beyond | $25 | 7% | Maurices | $20 | 7% | |||
| Best Buy | $25/$100/$250 | 3% | Men's Wearhouse | $25 | 8% | |||
| Blockbuster Gift Card | $10 | 7% | Michael's Arts & Crafts | $25 | 4% | |||
| Borders (Waldenbooks) | $10/$25 | 9% | Office Depot | $25/$100 | 4% | |||
| Build-A-Bear Workshop | $25 | 8% | Office Max | $25 | 5% | |||
| Cabela's | 25/$100 | 11% | Old Navy | $25 | 9% | |||
| Claire's/Icing | $10 | 9% | Overstock.com | $25 | 8% | |||
| Crate and Barrel | $25/$100 | 8% | PetSmart | $25 | 4% | |||
| CVS Pharmacy | $25/$100 | 6% | Payless Shoes | $20 | 13% | |||
| Dell Computers | $100 | 4% | Pier 1 Imports | $25 | 9% | |||
| Dillard's | $25/$100 | 9% | Pottery Barn/PB Teen/ Pottery Barn for Kids | $25/$100 | 8% | |||
| Disney Store | $25/$100/$1000 | 2% | Radio Shack | $25 | 4% | |||
| Dress Barn | $25 | 8% | Sally Beauty Company | $25 | 12% | |||
| Eddie Bauer | $25 | 9% | Sears | $25/$100/$250 | 4% | |||
| Fannie May | $10 | 25% | Shoe Carnival | $25 | 5% | |||
| Fashion Bug | $25 | 6% | Shutterfly | $25 | 9% | |||
| Finish Line | $25 | 10% | Sports Authority | $25 | 8% | |||
| Footlocker Stores/Lady Footlocker/Kid's Footlocker/Champs Sports) | $25 | 9% | Staples | $25/$100 | 5% | |||
| Gap/Gap Kids/Baby Gap | $25 | 9% | Target | $25/$100 | 2% | |||
| GameStop | $25 | 3% | The Childrens Place | $25 | 12% | |||
| GNC | $25 | 8% | Walgreens | $25/$100 | 6% | |||
| Gordmans | $25 | 7% | WalMart/Sam's Club | $25/$100$250 | 2% | |||
| Great Clips | $25 | 8% | ||||||
| Hallmark Gold Crown Stores | $25 | 4% | Grocery | |||||
| Gymboree | $25` | 13% | Cash Saver (New Athens) | $10/$20/$25/$50 | 4% | |||
| Harry & David | $25 | 10% | Shop-n-Sav | $25/$100 | 5% | |||
| Hi Way Lumber (ACE) New Athens | any denomination | 4% | ||||||
| Home Depot | $25/$100/$500 | 4% | Auto & Gasoline | |||||
| Home Shopping Network | $25 | 6% | Advance Auto Parts | $25 | 7% | |||
| Honey Baked Ham | $10 | 12% | Amoco/BP | $50/$100/$250 | 2% | |||
| iTunes | 15/$25 | 5% | Chevron | $50/$100/$250 | 2% | |||
| JCPenney | $25/$100 | 5% | Disney Vacations | $25/$100/$1000 | 2% | |||
| Jo Ann Fabrics | $20 | 6% | Exxon/Mobil | $50/$250 | 1.5% | |||
| Kay Jewelers | $50 | 6% | Jiffy Lube | $30 | 8% | |||
| K Mart | $25/$50 | 4% | Shell | $25/$50 | 1.5% | |||
| SuperAmerica (Speedway) | $25/$100 | 4% | ||||||
| See Reverse For More Retailers & Complete Ordering Info. | Total this page________________ | |||||||
| Merchant | Amount | % SA retains | Quantity | Services | ||||
| Restaurants | ||||||||
| Applebee's | $25/$50 | 8% | ChemLawn | $50 | 10% | |||
| Arby's | $10 | 8% | Merry Maids | $50 | 10% | |||
| Boston Market | $10 | 12% | Scrip Wallet | $1 | 15% | |||
| Burger King | $10 | 4% | Scrip Card File | $2.99 | 25% | |||
| California Pizza Kitchen | $10 | 4% | ||||||
| Casa Gallardo | $25 | 9% | ||||||
| Cheesecake Factory | $25 | 5% | ||||||
| Chevy's Fresh Mex Restaurant | $25 | 8% | Merchant | Amount | % SA retains | Quantity | ||
| Chili's/Romano's Macaroni Grill | $25 | 9% | Travel | |||||
| Chuck E. Cheese | $10 | 8% | American Airlines | $100/$250 | 8% | |||
| Cracker Barrel | $10 | 9% | BedandBreakfast.com | $50 | 10% | |||
| Cold Stone Creamery | $10 | 8% | Best Western Int'l | $25/$100 | 12% | |||
| Dave & Busters | $25 | 13% | Carnival Cruises | $100 | 8% | |||
| Dairy Queen Freeburg Only | $5 | 10% | Celebrity Cruise Lines | $100 | 9% | |||
| Del Taco | $10 | 4% | Clarion Hotels | $50/$100 | 4% | |||
| Denny's | $10 | 7% | Marriott Hotels | $50/$100/$500 | 12% | |||
| Dominos | $10 | 7% | Ritz-Carlton Hotels | $50 | 12% | |||
| Fazoli's | $25 | 7% | Disney Vacations | $25/$100/$1000 | 2% | |||
| Hard Rock Café | $25 | 10% | ||||||
| Hardees | $10 | 8% | Total this column______________ | |||||
| Hickory Farms | $10 | 15% | ||||||
| Jack in the Box | $10 | 4% | ||||||
| Joe's Crab Shack (Landry's) | $25 | 9% | Total front page_______________ | |||||
| KFC | $5 | 9% | ||||||
| Long John Silver's | $5 | 8% | ||||||
| Longhorn Steakhouse | $25 | 9% | Total back page_______________ | |||||
| Pizza Hut | $10 | 8% | ||||||
| Papa John's Pizza | $10 | 8% | GRAND TOTAL_______________ | |||||
| O'Charleys | $25 | 13% | ||||||
| Old Country Buffet | $25 | 5% | ||||||
| Olga's Kitchen | $20 | 8% | ||||||
| Olive Garden (Red Lobster) | $25 | 9% | Please make checks payable to St. Agatha Scrip. | |||||
| Outback Steakhouse | $25 | 8% | ||||||
| Quiznos | $10 | 10% | Orders will be placed every Monday morning and available the following weekend after mass or sent home with a St. Agatha School student. | |||||
| Ruby Tuesday’s | $25 | 8% | ||||||
| Ruth Chris Steak House | $50 | 10% | ||||||
| Saint Louis Bread Co. (Panera) | $10/$25 | 9% | Delivery information | |||||
| Steak N Shake | $10 | 7% | _____Please send my SCRIP home with____________ | |||||
| Subway | 10/$50 | 3% | ||||||
| TGI Friday's | $25 | 8% | ________________________________ Grade ________ | |||||
| Wendy's | $10 | 4% | ||||||
| Village Pizza & Deli | $20 | 10% | _____ I will pick up after mass | |||||
| _____ Scrip purchased at mass Total Paid_______ | ||||||||
| For more retailers go to www.glscrip.com | ||||||||
| Signature:______________________________________ | ||||||||
| If you have any questions please contact Maria Tiberend 475-2435 or 314-578-4732. | Date:__________________________________________ | |||||||
| Effective Jan 1, 2011 | Student/Family tuition designee___________________ | |||||||