Sacred Heart Catholic School   Order Name:  ___________________________________   
SCRIP Order Form     Phone:    ___________________________________   
      Tuition Credit For:  ___________________________________   
           (if not designating a specific child, can go directly to school) 
PAYMENT MUST ACCOMPANY ALL ORDERS     Make Checks payable to Sacred Heart School  
Vendor Percent Earned Amount Quantity Ordered Total $$ Vendor Percent Earned Amount Quantity Ordered Total $$
Amazon.com 4% $25.00     Kentucky Fried Chicken 9% 5.00    
American Airlines (TWA) 8% $100.00     Kmart 4% 25.00    
American Airlines (TWA) 8% $250.00     Kmart 4% 50.00    
American Eagle Outfitters 9% $25.00     Kohl's Dept. Store 4% 25.00    
Amoco (BP) 2% 50.00     Land's End 9% 25.00    
Applebees 8% 25.00     Lillian Vernon 21% 20.00    
Arby's 8% $10.00     Limited 9% 25.00    
Advance Auto Parts 7% $25.00     Linens N Things 8% 25.00    
Avon-BobbiJo Brown 20% $10.00     Logan's Roadhouse 8% 25.00    
B. Dalton (Barnes and Noble) 9% $10.00     Long John Silver's 9% 5.00    
B. Dalton (Barnes and Noble) 9% $25.00     Lowe's $25, $100,$500 4%      
Banana Republic 9% $25.00     Macaroni Grill (Chilli's) 11% 20.00    
Bath and Body Works 13% $10.00     Macy's 10% 25.00    
Bath and Body Works 13% $25.00     Macy's 10% 100.00    
Bass Pro Shops 7% $25.00     Marriott Hotels 12% 100.00    
Bed, Bath & Beyond 7% $25.00     Marshalls / T.J. Maxx 7% 25.00    
Belk 7% $25.00     Master Cuts (Regis Salons) 8% 25.00    
Best Buy 2% $100.00     Mrs. Field's Cookies  10% 5.00    
Best Western 12% $25.00     Office Depot 4% 25.00    
Blockbuster $3.79 Single Rental 15% $3.79     Office Max 5% 25.00    
Blockbuster $10 Gift Card 7% $10.00     Old Navy (The Gap) 9% 25.00    
Boscov's 5% $25.00     Olive Garden (Darden) 9% 25.00    
Build a Bear 8% $25.00     On the Border (Chili's) 11% 20.00    
Carnival Cruises 8% $100.00     Outback Steakhouse 4% 25.00    
Chili's 11% $20.00     Papa John's Pizza 8% $10.00    
Chuck E. Cheese 8% $10.00     Payless Shoes 13% $20.00    
Circuit City $50, $100 3%       Pier 1 Imports 9% $25.00    
Claire's 9% $10.00