Scrip Certificate Order Form (November 15, 2005)

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Merchant name

% Denominations Merchant Name % Denominations
1-800- Flowers 8% $15 Lady's Footlocker 8% $10   $25
Ace Hardware 4% $25 Lerner 10% $20
Amazon.com 4% $25 Lillian Vernon 17% $15
Advanced Auto   $25 Limited 9% $25
American Airlines 12% $50 Linens N Things 10% $25
American Eagle Outfitters 8% $25 Tony' Roma's 9% $20
Applebee's 8% $20 Tower Records 7% $10
AT&T PrePaid Card 20% $9.50 Towne Place Suites 12% $25
Babies 'R' Us 3% $20 Toys "R" Us 3% $10  $20
Baby Gap 9% $20   $25   $50 Long John Silvers 5% $5
Bahama Breeze 14% $10   $25 Lowe's Home Center 3% $25   $100
Banana Republic 9% $25 Macy's ** 9% $25   $100
Barnes & Nobles/B Dalton 9% $10   $25 Marriott International * 12% $25
Baskin Robbins 9% $2 Marshalls 9% $10   $25
Bass Pro Shops 6% $25 Max & Erma's   $10
Bath and Body Works 13% $10   $25    Men's Warehouse 8% $25
Bed, Bath, and Beyond 6% $25 Mobile/Exxon 1.5% $50
Belk 7% $25 Motherhood   $25
Bennigan's 13% $25 Mrs. Fields (cookie) 25% $5
Best Buy 2% $25   $100 Old Navy 9% $25
Black Angus 15% $20 Olive Garden 14% $25
Blockbuster Video 7% $10   $25 Original Cookie Co. 25% $5
Bonefish Grill 4% $25 Outback Stakehouse 4% $25
Borders/Waldenbooks 8% $10   $25 Paragon (Whaling Co.) 19% $10
Boston Market 12% $10 Payless Shoesource 13% $20
Burger King 4% $5 Pep Boys 4% $20
Carnival Cruise Lines 10% $25   $100 Pier One Imports 9% $25
Casual Corner ** 19% $25 Pizza Hut 9% $10
Children's Place (The) 12% $25 Radio Shack 4% $25
Chili's 11% $20 Rainforest Café 13% $10
Chuck E.Cheese 7% $10 Red Lobster 14% $10   $25
Circuit City 4% $50   $100 Rite Aid 5% $25
Claires 7% $10 Ross Dress for Less 8% $25
CompUSA   $25 Ruby Tuesday 9% $25
Courtyard (Marriott) 12% $25 Sally's Beauty 5% $25
Crate & Barrel   $25 Sam Goody 9% $20
Cracker Barrel 9% $10 Sara Lee Outlet Stores 13% $10
CVS Pharmacy 2% $25 Sears ** 4% $25  $100  $250
Denny's 9% $25 Sharper Images 12% $50
Dick's Sporting 9% $5 Shell Debit Card 2% $25  $100
Dillard's 9% $5 Shoe Carnival 5% $25
Domino's Pizza 5% $5 Smoky Bones BBQ 14% $25
Don Pablo's 8% $25 Speedway 4% $25  $100
Dress Barn 8% $20 Sports Authority 6% $25
Eckerd Drug (JC Penny) 5% $10   $25   $100 Staples 5% $25  $100
Exxon/Mobile 3% $50 Starbucks 8% $10  $25
Fairfield Inn (Marriott) 12% $25 Steak &Ale 18% $10  $25
Family Christian Bookstore 9% $10 Stein Mart (not NW) 8% $20
Farm Fresh 5% $5  $10  $20  $50  $100  Stop & Shop 4% $25  $100
Food Lion 5% $10  $25  $50  $100 Sunglass Hut 9% $25
Footlocker (all) 9% $10  $25 Super Kmart 2% $25  $50
Friendly's 8% $5 TCBY 25% $5
Fuddruckers 8% $10 TGI Fridays 13% $20
Gap/Gapkids/Babygap 9% $25 Texas Roadhouse 8% $25
Giant Foods 4% $10   $25 Timberland 15% $25
GNC 6% $25 T J Maxx 9% $10  $25
Hard Rock Café 7% $25 Uno Chicago Bar & Grill 15% $25
Home Depot ** 3% $25   $100 Value City 9% $10
Hyatt Hotels 9% $25 Verizon   $10
JC Penny 5% $25   $100 Waldenbooks/Borders 8% $10  $25
Jo-Ann Fabrics 6% $20 WaWa's 1.5% $25
Joes Crab Shack 9% $25 Wendy's 9% $10
Johnny Rocket's 8% $5 Whaling Co. 19% $10  $25
Kmart 2% $25   $50 Warehouse Music 8% $10
KB Toys/Toy Works 9% $10 Williams-Sonoma 13% $25  $100
K F C 9% $5 Winn Dixie 5% $25  $50
Kids Footlocker 8% $10 Zany Brainy   $10
Kids 'R' Us  3% $10   $20   $25   $50      
Kroger 4% $20      
           
           
           
           
           
           
           
           
           

Most Scrip is kept in stock.  If we are out of what you order, we can get it in a few days.
*Not for catering and group rooms.    **No payment on account.    ***Catalog and Website.
You may use Scrip to pay store charge account, in person only, at JC Penny.
Please make checks payable to: Hampton Christian Schools.

 

Parent's Name:                                                Phone:                                                Date:                           

Student's Name:                                                 Teacher:                                                Total:                      

Parent Pickup:                        Child Take Home:                                 Signature:                                            

Please be sure to indicate pickup/delivery method and sign.