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SDA Schools SCRIP Program Order Form
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5140 Calvert, Lincoln NE 68506
Ph 483-1181 |
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An ongoing Fundraising Campaign Supported by the Parents and friends |
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of Helen Hyatt and CVA |
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| The following items are being discontinued and we have a few left to sell: |
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| Dick's Sporting Goods 3-$25 Gap-5-$20 TGI Friday's 5-$20 T J Maxx 4-$25 |
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| Baskin Robbins 12-$2 Olive Garden-1-$10 Eddie Bauer 1-$20 Home Depot 2-$50 & 1-$100 |
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| Vendors |
% |
$ |
# |
Net Amount |
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Vendors |
% |
$ |
# |
Net Amount |
| Grocery/Drug |
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Department Stores |
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| Russ's Market |
5% |
$20 |
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Prepaid Debit Card |
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| Prepaid Debit Card |
$50 |
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Dillards |
9% |
$25 |
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$100 |
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J C Penney |
6% |
$25 |
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| Super Saver |
3% |
$20 |
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6% |
$100 |
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| Prepaid Debit Card |
$50 |
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Sears |
4% |
$25 |
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$100 |
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$100 |
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| 4 Star Drug |
3% |
$10 |
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Shopko |
4% |
$25 |
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$50 |
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| Restaurants |
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Specialty Stores |
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| Amigo's |
10% |
$5 |
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Barnes & Noble |
9% |
$10 |
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| Applebee's |
8% |
$20 |
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$25 |
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$25 |
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Bath & Body Works |
13% |
$10 |
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| Burger King |
4% |
$10 |
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$25 |
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| Carlos O' Kelly |
9% |
$10 |
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Bed Bath & Beyond |
7% |
$25 |
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| Chipotle |
6% |
$10 |
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Best Buy |
2% |
$25 |
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| Chili's/Macaroni |
11% |
$25 |
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$100 |
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| Cracker Barrel |
8% |
$10 |
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Eddie Bauer |
12% |
$25 |
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| Davinci's |
10% |
$5 |
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Family Christian |
9% |
$10 |
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| Famous Daves |
10% |
$20 |
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Gap/Banana/Old Navy |
9% |
$25 |
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| KFC |
9% |
$5 |
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Home Depot |
3% |
$25 |
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| Mr. Goodcents |
7% |
$5 |
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Kohl's |
4% |
$25 |
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| Noodles & Co. |
8% |
$10 |
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Home Depot |
4% |
$100 |
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| Old Country Buffet |
5% |
$25 |
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Lowe's |
4% |
$25 |
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| Olive Garden |
9% |
$25 |
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Lowe's |
4% |
$100 |
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| Outback |
4% |
$25 |
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Menards |
3% |
$25 |
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| Panera |
9% |
$10 |
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Office Max |
5% |
$25 |
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| Pizza Hut |
9% |
$10 |
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Payless Shoes |
13% |
$20 |
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| Red Robin |
9% |
$10 |
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Pier 1 Imports |
4% |
$10 |
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| Ruby Tuesday |
8% |
$10 |
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$25 |
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| Starbucks |
7% |
$10 |
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Sally Beauty |
12% |
$25 |
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$25 |
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Steve & Barry |
6% |
$25 |
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| Subway |
3% |
$10 |
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Toys R Us |
3% |
$20 |
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| Taco Inn |
10% |
$5 |
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| Valentinos |
9% |
$5 |
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Entertainment |
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Blockbuster Video |
7% |
$10 |
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| Method of Receiving Scrip (check one) |
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Total Amount Due _____________________ |
| ________ 1. Send home with student at my risk |
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payment must accompany order |
| ________________________________ |
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| Student name, grade, teacher |
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**The percent listed after each vendor is the amount |
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SDA Schools earns even though you pay face value! |
| ________2. Pick up at Helen Hyatt Office |
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Make checks payable to SDA Schools of Lincoln |
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| Name _______________________________________ |
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| Address _____________________________________ |
Phone (home) _________________________ |
____________________ |
| ______________________________________ |
(office) _________________________ |
Date |
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| **Interested in a vendor not listed please let us know and we will see if it is available. _____________________ |
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