Piedmont Academy Scrip Order Form [PDF]

Piedmont Academy Scrip Order Form Order Online at www.shopwithscrip.com Enrollment Code CB8C55E637363 RESTAURANTS

%

Value

QTY

Total

Taco Bel

5.00%

$10

$

Applebee's

8.00%

$25/$50

$

TGI Friday's

9.00%

$25

$

Arby's

8.00%

$10

$

Wendy's

4.00%

$10

$

Bonefish Grill

8.00%

$25

$

Buffalo Wild Wings

8.00%

$10/$25

$

BP

1.50%

$50/$100

$

Burger King

4.00%

$10

$

Chevron

1.50%

$50/$100

$

Caribou Coffee

6.00%

$10

$

Circle K

1.50%

$25/$100

$

Carrabba's Italian Grill

8.00%

$25/$50

$

Exxon/Mobil

1.50%

$50

$

Cheesecake Factory

5.00%

$25

$

Marathon

3.00%

$25/$100

$

Chili’s

11.00%

$25/$50

$

Chuck E. Cheese

8.00%

$10

$

Speedway

4.00%

$25/$100

$

Cold Stone Creamery

8.00%

$10

$

Sunoco

1.50%

$50

$

Cracker Barrel

9.00%

$10/$25

$

Texaco

1.50%

$50/$100

$

Dairy Queen

3.00%

$10

$

Dave & Buster’s

13.00%

$25

$

Ace Hardware

4.00%

$25/$100

$

Del Taco

4.00%

$10

$

Adidas

13.00%

$25

$

Denny's

7.00%

$10

$

Advance Auto Parts

7.00%

$25

$

Domino's Pizza

8.00%

$10

$

Aerie

10.00%

$25

$

Dunkin Donuts

3.00%

$10

$

Honey Baked Ham

12.00%

$25

$

Albertons

4.00%

$25/$100

$

IHOP Restaurant

8.00%

$25

$

Amazon.com

3.00%

$25/$100

$

Krispy Kreme

8%

$10

$

Academy Sports

4%

$25

$

Little Caesar's Pizza

8.00%

$20

$

American Eagle

10%

$25

$

American Girl

9.00%

$25/$100

$

GAS

RETAILERS

%

%

Value

Value

QTY

QTY

Total

$

Longhorn

9.00%

$25

$

Auto Zone

8.00%

$25

$

Macaroni Grill

11.00%

$25/$50

$

Babies-R-Us

3.00%

$20/$100

$

Maggiano's Little Italy

11.00%

$25/$50

$

14.00%

$25/$100

$

O'Charley's

15.00%

$25

$

Olive Garden

9.00%

$25

$

Banana Republic (Gap,Old Navy) Barnes & Noble

9.00%

$10/$25/$100

$

Omaha Steaks

11.00%

$25/$50

$

Bass Pro Shops

9.00%

$25/$100

$

On The Border

11.00%

$25/$50

$

Bath & Body Works

13.00%

$10/$25

$

Outback Steak House

8.00%

$25/$50

$

Bed, Bath, & Beyond

7.00%

$25/$100

$

P.F. Chang's Bistro

8.00%

$25

$

Belk

8.00%

$25/$100

$

Panda Express

8.00%

$25

$

Best Buy

3.00%

$25/$100

$

Panera Bread

9.00%

$10/$25

$

Papa John's

8.00%

$10

$

Pizza Hut

8.00%

$10

$ $

Red Lobster

9.00%

$25

$

Ruby Tuesday

8.00%

$25

$

Starbucks

7.00%

$10/$25

$

Steak 'N Shake

8.00%

$10

$

Subway

3.00%

$10/$50

$

$ Boston Market

12.00%

$10

$

Brooks Brothers

16.00%

$25

$

Build-A-Bear Workshop

8.00%

$25

$

Burlington Coat Factory

8.00%

$25

$

Cabela's

11.00%

$25/$100

$

Children's Place, The

12.00%

$25

$

Clair's/Icing/Afterthoughts

9.00%

$10

$

Columbia

12%

$50

$

Crate and Barrel

8.00%

$25/$100

$

Make Checks Payable to PAC Scrip

Piedmont Academy Scrip Order Form Order Online at www.shopwithscrip.com Enrollment Code CB8C55E637363 Carazy 8

13.00%

$25

$

Peebles/Stage Stores

8.00%

$25

$

CVS

6.00%

$25/$100

$

Pep Boys

4.00%

$20

$

Dick's Sporting Goods

8.00%

$25/$100

$

Pet Smart

4.00%

$25

$

Dilliard's

9.00%

$25/$100

$

Pier 1

9.00%

$25

$

Disney

2.00%

$25/$100

$

Pottery Barn

8.00%

$25/$100

$

Dress Barn

8.00%

$25

$

Regal Entertainment Group

8.00%

$25

$

EB Games

3.00%

$25

$

REI (Recreational Equip. Inc.)

8.00%

$25

$

Finish Line

10%

$25

$

Rite Aid

4.00%

$25

$

Foot Locker

9%

$25

$

Ross Dress for Less

8.00%

$25

$

Gap

14.00%

$25/$100

$

Sally Beauty

12.00%

$25

$

Game Stop

3.00%

$25

$

Sams Club

2.50%

$25/$100

$

Gander Mountain

8.00%

$25

$

Sears

4.00%

$25/$100

$

$

Sephora

5.00%

$20

$

Shoe Carnival

5.00%

$25

$

Goody’s

8.00%

$25

$

Great Clips

8.00%

$25

$

Groupon.com

7.00%

$25

$

Gymboree

13.00%

$25

$

Home Goods

7.00%

$25/$100

$

Staples

5.00%

$25/$100

$

I-Tunes

5.00%

$15/$25

$

Stein Mart

7.00%

$10/$25

$

J. Crew

13.00%

$25

$

Tanger Outlet Stores

8.00%

$25

$

JC Penny

5.00%

$25/$100

$

Target

2.50%

$25/$50/$100

$

$

T.J. Maxx

7.00%

$25/$100

$

ToysRUs/BabiesRUs/KidsRUs

3.00%

$20/$100

$

$ Shutterfly

9.00%

$25

$ $

Jiffy Lube

8.00%

$30

$

JoAnn Fabrics

6.00%

$25

$

Journeys

10.00%

$25

$

Under Armour

11.00%

$25

$

Kmart

4.00%

$25/$50

$

United Artist Theaters

8.00%

$25

$

Kohl's

4.00%

$25/$100

$

Walgreen's

6.00%

$25/$100

$

L.L. Bean

16.00%

$25/$100

$

Walmart

2.50%

$25/$100

$

Land's End

16.00%

$25/$100

$

Whole Foods

3.00%

$25/$100

$

Lord & Taylor

8.00%

$25

$

8.00%

$25/$100

$

Lowe's

4.00%

$20/$100

$

Macy's

10.00%

$25/$100

$

Williams-Sonoma/Pottery Barn Winn Dixie

4.00%

$25/$100

$

Marshall's / TJ Maxx

7.00%

$25/$100

$

Zappos.com

8.00%

$25/$100

$

Maurices

7.00%

$20

$

Meijer

3.00%

$25/$50/$100

$

Michael's

4.00%

$25

$

Nike

12%

$25

$

Nook by B&N

9%

$10/$25/$100

Office Depot/Office Max

5%

$25/$100

$

Old Navy (Gap, Banana Republic) Oriental Trading

14.00%

$25/$100

$

Email _____________________________________________

9.00%

$25

$

Student Name and Grade ____________________________

Overstock.com

8.00%

$25

$

Payless Shoes

13.00%

$20

$

$

Total Check # _______________

$

Cash$______________

Phone____________________________________________

Send Home with Student or Pick Up

Make Checks Payable to PAC Scrip

Piedmont Academy Scrip Order Form Order Online at www.shopwithscrip.com Enrollment Code CB8C55E637363

Make Checks Payable to PAC Scrip