DESOTO GIFT CERTIFICATE PROGRAM - SCRIPS - ORDER FORM
ORDER FORM DUE:
STUDENT NAME:							TEACHER:
	SELECT ONE:  Send home with child
							Parents Signature:
	Pick up in school office
							Phone Number:
RETAIL STORES	Denomination	DeSoto %		Qty	Amt. Ordered		RESTAURANTS	Denomination	DeSoto %		Qty	Amt. Ordered
Aeropostale	$25	7%
American Eagle Outfitters	$25	9%	Retail Store				Applebee's	$25	8%
Banana Republic	$25	9%	Retail Store				Arby's	$10	8%
Barnes & Noble / B. Dalton	$10	8%					Baskin Robbins	$2	9%	Restaurant
Barnes & Noble / B. Dalton	$25	8%	Retail Store				Buca Di Beppo	$25	11%
Bath & Body Works	$10	13%	Retail Store				Bob Evans	$10	10%	Restaurant
Bath & Body Works	$25	13%					Burger King	$10	4%	Restaurant
Bed Bath & Beyond	$25	7%	Retail Store				Carlos O’Kelley	$10	9%
Best Buy	$25	2%	Retail Store				Cheeseburger in Paradise	$25	5%
Best Buy	$100	2%					Cheesecake Factory	$25	5%	Restaurant
Blockbuster Single Rental	3.79	15%					Chili’s/On the Border	$25	11%
Blockbuster Gift Card	$10	7%	Retail Store				Chuck E. Cheese	$10	8%	Restaurant
Borders / Waldenbooks	$10	9%	Retail Store				Cold Stone Creamery	$10	8%
Build-A-Bear	$25	8%					Cracker Barrel	$10	9%
Catherines	$25	6%	Retail Store				Dairy Dream	$5	10%			A
Claire's / Afterthoughts/Icing	$10	9%	Retail Store				Dennys	$10	7%
Dick's Sporting Goods	$25	8%	Retail Store				Domino's Pizza	$5	5%
Dillard's	$25	9%					Dunkin Donuts	$10	4%	Restaurant
Disney	$25	2%					Fazoli's	$25	7%
Disney	$100	2%					Hard Rock Café	$25	10%
Dunham's	$25	8%					Kent. Fried Chicken	$5	9%	Restaurant
Elder Beerman's	$25	8%					Long John Silver's	$5	8%	Restaurant
Family Christian Stores	$25	9%	Retail Store				Maggiano's	$25	11%
Finishline	$25	10%	Retail Store				Noodles & Company	$10	8%
Footlocker/Lady/Kids Footlocker	$25	9%					O'Charley's	$25	13%	Restaurant
GameStop/EB Games	$25	3%	Retail Store				Olive Garden	$25	9%	Restaurant
Gander Mountain	$25	8%					Outback Steakhouse	$25	5%	Restaurant
Gap	$25	9%					P.F. Changs	$25	7%
GNC	$25	8%					Panera Bread	$10	9%			A
Gymboree	$25	10%					Papa John's Pizza	$10	8%
Hallmark	$25	4%					Pizza Hut	$10	8%	Restaurant
Home Depot	$25	3%	Retail Store				Qdoba	$25	7%
Home Depot	$100	3%					Rainforest Café	$25	9%
Icing	$10	9%					Red Lobster	$25	9%	Restaurant
Itunes	$15	4%					Ruby Tuesday’s	$25	8%
JCPenney	$25	5%	Retail Store				Starbucks	$10	7%	Restaurant
JCPenney	$100	5%					Steak and Shake	$10	8%
Jo Ann Fabrics	$20	6%	Retail Store				Subway	$10	3%	Restaurant
K Mart	$25	4%					Texas Roadhouse	$25	8%
K Mart	$50	4%					TGI Friday’s	$25	9%
Kohls	$25	4%					Wendy’s	$10	4%
Kohls	$100	4%					OTHER SCRIP PROVIDERS
LL Bean	$25	15%					Autozone	$25.00	5%
Lane Bryant	$25	6%					Advance Auto	$25	7%
Limited	$25	9%	Retail Store				Jiffy Lube	$30	8%
Lowe's Home Improvement	$25	4%	Retail Store				HSN	$25	6%
Lowe's Home Improvement	$100	4%					GROCERIES
Macys	$25	10%
MC Sports	$25	8%					Gordon Food Service	$25	4%			A
Maurices	$20	7%	Retail Store				Marsh/LoBill Grocery	$10	5%
Menards Home Centers	$25	3%	Retail Store				Marsh/LoBill Grocery	$20	5%			A
Menards Home Centers	$100	3%
Old Navy	$25	9%	Retail Store				PHARMACIES
Payless Shoes	$20	13%	Retail Store				CVS Pharmacy	$25	6%	Retail Store
Pet Smart	$25	4%					Walgreen's	$25	6%	Grocery
Radio Shack	$25	4%
Sam's Club	$25	2%					CATALOGS & INTERNET
Sam's Club	$100	2%					Amazon.com	$25	4%	Retail Store
Sears	$25	4%	Retail Store				Cabela's / 800-237-4444	$25	11%
Sears	$100	4%					Lands End	$25	9%
Shoe Carnival	$25	5%					Lands End	$100	9%
Staples	$25	5%	Retail Store				Bass Pro Shop	$25	9%
T.J. Maxx	$25	7%					Overstock.com	$25	8%
The Children's Place	$25	12%	Retail Store				Zappos.com	$25	8%
Toys/Babies/Kids-R-Us	$20	1%	Retail Store
Wal-Mart	$25	2%
Wal-Mart	$100	2%					TOTAL AMOUNT ORDERED:
			Retail Store
							Check #
GAS STATIONS
BP Gas	$50	2%					Check Amount:
Marathon	$25	3%
Marathon	$100	3%					Cash Amount:
Shell Gas	$25	1%			A		Post-Payment is available.  Call the office for information.
Shell Gas	$100	1%
Speedway	$25	4%			A		Make checks payable to DeSoto Elementary PTO.
Speedway	$100	4%