FHNBB Scrip Program (effective July 18 – August 1, 2017)

Student Name/Account: __________________________________________

Parent/Guardian Name: __________________________________________

Date: _________________________________________________________

Cell Phone #: ___________________________________________________

Groceries

Merchant Value % Quantity Total $

Dierbergs $25 4.5%

Dierbergs $100 4.5%

Schnucks $25 2%

Schnucks $100 2%

Shop ‘N Save $25 5%

Shop ‘N Save $50 5%

Shop ‘N Save $100 5%

Whole Foods $25 3%

Whole Foods $100 3%

Gasoline

Merchant Value % Quantity Total $

Huck’s $25/$50 2%

Mobil/Exxon $50 1%

Mobil/Exxon $250 1%

Motomart $50 5%

Phillips 66/Conoco/76 $25 1.5%

Phillips 66/Conoco/76 $100 1.5%

Quick Trip $25 1.25%

Quick Trip $50 1.25%

Quick Trip $100 1.25%

Shell $25 3%

Shell $50 3%

Shell $100 2%

Travel

Merchant Value % Quantity Total $

Avis Car Rental $50 8%

Budget Car Rental $50 8%

Best Western $25/$100 12%

Comfort Inn/ Choice Hotels $50/$100 3%

Fairmont Hotels $100 9%

Hilton Hotels $100/$500 2%

Hyatt Hotels $50/$100 9%

Princess Cruise Lines $100/$500 8%

Other

Merchant Value % Quantity Total $

Advance Auto Parts $25/$100 7%

Amazon.com $25/$100 4.5%

Amazon.com $50 4%

AMC Theaters $25 8%

Auto Zone $25 8%

GameStop $25 12%

Great Clips $25 8%

Groupon $25 7%

iTunes $15 5%

iTunes $25 5%

Jiffy Lube $30 8%

Shutterfly $25 9%

SuperCuts $25 8%

Overstock.com $25 8%

Zappos.com $25/$100 8%

FFC: $ ________________________

Restaurants

Merchant Value % Quantity Total $

Applebee’s $25/$50 8%

Arby’s $10 8%

Bandana’s BBQ $25 8%

Bob Evans $10 12%

Buffalo Wild Wings $25 14%

Burger King $10 4%

California Pizza Kitchen $25 8%

Cecil Whitaker’s $20 10%

Cheesecake Factory $25 5%

Chevy’s $25 8%

Chick Fil A $10 3%

Chili’s/Maggiano’s $25/$50 18%

Chipotle $10 12%

Chuck E. Cheese $10 8%

Cold Stone Creamery $10 8%

Cracker Barrel $10/$25 8%

Dairy Queen $10 3%

Dave & Buster’s $25 15%

Denny’s $10 7%

Domino’s Pizza $20 14%

Dunkin’ Donuts $10/$25 3%

Fazoli’s $25 7%

Hardees $10 5%

Houlihan’s $25 8%

IHOP $25 8%

Goodcents Deli Fresh Subs $10 12%

Imo’s Pizza $20 3%

Jack in the Box $10 4%

Lion’s Choice $25 3%

Little Caesars Pizza $20 8%

Long John Silver’s $10 8%

McDonald’s $15 2%

Mimi’s Café $25 8%

Noodles and Company $10 8%

O’Charleys $25 13%

Oberweis $10 8%

Olive Garden/Longhorn (Darden Restaurants)

$25 8%

Outback Steakhouse $25 12%

Panda Express $25 8%

Papa John’s $10 8%

Papa Murphy’s $10 8%

Pasta House (paper cert.) $25 12%

Penn Station $10 5%

PF Chang’s/Pei Wei $25 8%

Pizza Hut $10 8%

Potbelly Subs $10 8%

Qdoba $25 7%

Red Lobster $25 9%

Red Robin $25 11%

Ruby Tuesday’s $25 8%

Smashburger $10 10%

St. Louis Bread Co./Panera $10/$25 8%

Starbucks $10/$25 7%

Steak ‘n Shake $10 8%

Steak ‘n Shake $25 12%

Subway $15/$25 9%

Taco Bell $10 5%

Texas Roadhouse $25 8%

TGI Fridays $25 15%

Wendy’s $10 4%

Total # cards page 1: __________ Total $ page 1: __________

Retail Stores

Merchant Value % Quantity Total $

American Eagle $25 10%

American Girl $25/$100 9%

Barnes & Noble $10/$25/$100 10%

Bass Pro $25/$50 14%

Bass Pro $100 9%

Bath & Body Works $10/$25 18%

Bed, Bath, and Beyond $25/$100 8%

Best Buy $25/$50 10%

Build-A-Bear Workshop $25 10%

Cabela’s $25/$100 14%

Children’s Place $25 14%

Claire’s/Icing $10 9%

Columbia Sportswear $50 14%

Container Store $25/$100 9%

Costco $50/$100 1.5%

Crate and Barrel $25/$100 8%

CVS $25/$100 9%

Dick’s Sporting Goods $25/$100 8%

Dillard’s $25/$100 9%

Disney Parks and Stores $50 4%

Dressbarn $25 8%

Express $25 10%

Famous Footwear $25 8%

Foot Locker $25 8%

Hallmark $25 6%

Home Depot $25/$50$100 4%

Home Depot $500/$1,000 4%

JC Penney $25/$50 7%

Jo Ann’s Fabrics $25 6%

Journeys $25 10%

Kohl’s – can use for credit payment

$25/$50/$100 4%

Kohl’s – NOT for credit payment

$25 8%

Land’s End $25/$100 16%

Lane Bryant $25 8%

LL Bean $25/$100 17%

Lord and Taylor $25 8%

Lowe’s Hardware $25/$50/$100 5%

Lowe’s Hardware $500/$1,000 4%

Macy’s $25/$100 12%

Menards $25/$100 3%

Michael’s $25 6%

Nike $25 12%

Nordstrom $25/$100 6%

Office Depot/Office Max $25/$100 5%

Old Navy/Gap/Banana Republic/ Athleta

$25/$100 14%

Petsmart $25 5%

Pottery Barn/West Elm/ Willams-Sonoma

$25/$100 8%

REI $25 8%

Ross Dress for Less $25 8%

Sears $25/$100/$250 4%

Sephora $20 7%

Talbot’s $25 13%

TJ Maxx/ Marshall’s/Home Goods

$25/$100 9%

Target $25/$50/$100 4.5%

Toys R Us $25 8%

Under Armour $25 14%

Walmart/Sam’s $10/$25 2.5%

Walmart/Sam’s $100/$250 2.5%

Search glscrip.com for other available merchants. Write in the information below.

Merchant Value % Quantity Total $

Scrip reminders:

Cash and checks (payable to FHNBB) accepted.

Always check your cards at pick-up before you leave to make sure your order matches the cards in your envelope.

Except for the 4% Kohl’s cards, most scrip cards cannot be used to make credit payments.

Percentages and dollar amounts can change without notice.

More merchants are available: check glscrip.com for the complete list.

Local vendor specials can end without notice.

******************************************* Please total your order:

# of cards Amount of $ Page 1: ________ $_________ Page 2: ________ $_________ Totals= ________ $_________

Checks made payable to FHNBB

*******************************************

Scrip contact: Matt Temper 314-602-6994 scrip@fhnbands.com