WMS Scrip Funding Program | Family Order Form What is Scrip, you ask? It’s an easy , convenient way to support Western. Just purchase gift cards for the places you already shop! Western will recieve a percentage of the value of your card purchase at no extra cost to you!
Name:
Date:
Email:
Phone:
Please select your delivery preference:
Pick up from school
Total Due from all columns: Please make checks payable to: Western Mennonite School
Send home with:
As you look over the order form to make selections, please consider the smaller gift card denominations as gifts themselves or purchase the larger denominations for all your upcoming Christmas shopping, groceries or perhaps the following: Do you have home projects coming up? Please consider purchasing a gift card for Home Depot or Lowes before you head there. Road Trip planned? We have hotels and gas cards available as well. Will you be heading to the movies over the holidays? Order yourself a Regal Cinema Movie Gift Card!
Please take a moment to check out the many, many merchants available. There is something for everyone! Clothing & Accessories Product
7%
$
Department Store
7%
$
Product
% QTY
Total
Total
Marshalls $25.00
Aeropostale $25.00
10%
$
Maurices $20.00
7%
$
Sears $100.00
4%
$
American Eagle Outfitters $25.00
10%
$
Men's Wearhouse $25.00
8%
$
Sears $25.00
4%
$
Banana Republic $25.00
14%
$
Old Navy $100.00
14%
$
Sears $250.00
4%
$
14%
$
Sears Auto Service Center $100.00
$
$
Old Navy $25.00
4%
9% 12%
$
Payless Shoes $20.00
13%
$
Sears Auto Service Center $250.00
4%
$
Dressbarn $25.00
8%
$
Ross Dress for Less $25.00
8%
Foot Locker $25.00
8%
$
T.J. Maxx $100.00
Claire's $10.00 Columbia Sportswear $50.00
% QTY
Marshalls $100.00
T.J. Maxx $25.00
Gap $100.00
14%
$
Gap $25.00
14%
$
Gap Factory $100.00
14%
$
Gap Factory $25.00
14%
$
Gymboree $25.00
13%
$
HomeGoods $100.00
7%
$
Department Store
HomeGoods $25.00
7%
$
Product
J. Crew $25.00
$
Dining - Casual
7%
$
Product
7%
$
Applebee's® $10.00
8%
$
$
Applebee's® $25.00
8%
$
Applebee's® $50.00
8%
$
12%
$
8%
$
11%
$
Cracker Barrel $10.00
8%
$
Cracker Barrel $25.00
8%
$
Denny's $10.00
7%
$
IHOP $25.00
8%
$
Olive Garden ® $10.00
8%
$
Olive Garden ® $25.00
8%
$
T.J. Maxx/Marshalls/HomeG oods $100.00
7%
T.J. Maxx/Marshalls/HomeG oods $25.00
7%
$
Under Armour® $25.00
11%
$
% QTY
Total
Boston Market $10.00 Buffalo Wild Wings $25.00 Chili's Grill & Bar $25.00
% QTY
Total
13%
$
JCPenney $100.00
5%
$
8%
$
JCPenney $25.00
5%
$
L.L.Bean $100.00
16%
$
Kohl's $100.00
4%
$
L.L.Bean $25.00
16%
$
Kohl's $25.00
4%
$
Lady Foot Locker $25.00
8%
$
Macy's $100.00
10%
$
$
10%
$
Outback Steakhouse $10.00
$
16%
Macy's $25.00
8%
Lands' End $100.00 Lands' End $25.00
16%
$
Nordstrom $100.00
6%
$
Outback Steakhouse $25.00
8%
$
Lands' End Kids $100.00
16%
$
Nordstrom $25.00
6%
$
8%
$
Nordstrom Rack $100.00
6%
$
Outback Steakhouse $50.00 Red Lobster $10.00
8%
$
Nordstrom Rack $25.00
6%
$
Red Lobster $25.00
8%
$
Kids Foot Locker $25.00
Health & Beauty
Discount Store
Dining - Casual Total
Product
Total
Product
Red Robin $25.00
8%
$
Walmart $10.00
2.5%
$
Sally Beauty Supply $25.00
Ruby Tuesday $25.00
8%
$
Walmart $100.00
2.5%
$
Texas Roadhouse $25.00
8%
$
Walmart $25.00
2.5%
$
TGI Fridays® $25.00
9%
$
Walmart $250.00
2.5%
Walmart $50.00
2.5%
Product
% QTY
Dining - Fine Product P.F. Chang's China Bistro $25.00
% QTY 8%
Total $
Dining - On The Go Product
% QTY
Total
% QTY
% QTY
Total $
ULTA $25.00
4%
$
Walgreens $100.00
5%
$
$
Walgreens $25.00
5%
$
$
White Barn Candle Co $10.00
13%
$
Electronics & Office Product
% QTY 12%
Total
Best Buy® $100.00
4%
$
Best Buy® $25.00
4%
$
Best Buy® $250.00
4%
GameStop $25.00
Home Decor Product
% QTY
Total
Bed Bath & Beyond $100.00
7%
$
$
Bed Bath & Beyond $25.00
7%
$
3%
$
$
$
Crate and Barrel $100.00
8%
5%
Arby's $10.00
8%
$
Burger King $10.00
4%
$
Carl's Jr. $10.00
5%
$
Office Depot / Office Max $25.00
Crate and Barrel $25.00
8%
$
$
Staples $100.00
5%
$
Land of Nod $100.00
8%
$
Staples $25.00
5%
$
Pier 1 Imports $25.00
9%
$
Pottery Barn $25.00
8%
$
Pottery Barn Kids $25.00
8%
$
Chipotle Mexican Grill $10.00
10%
Chipotle Mexican Grill $25.00
10%
$
Cold Stone Creamery $10.00
8%
$
Dairy Queen $10.00
3%
$
Dunkin' Donuts $10.00
3%
$
Great Harvest Bread $10.00
6%
$
Little Caesar's Pizza $20.00
8%
Panera Bread $10.00
Entertainment Product
% QTY
Total
Barnes & Noble $25.00
8%
$
Regal Theatres $10.00
8%
$
Regal Theatres $25.00
8%
$
$
Regal Theatres Premiere Movie Ticket $10.00
10%
$
8%
$
Gas & Auto
Panera Bread $25.00
8%
$
Product
Panera Bread $5.00
8%
$
76 Gas $100.00
1.5%
$
Papa John's Pizza $10.00
8%
$
76 Gas $25.00
1.5%
$
Peet's Coffee & Tea $20.00
8%
$
ARCO $100.00
1.5%
$
ARCO $250.00
1.5%
$
Pizza Hut (Not AK or HI) $10.00
8%
$
Starbucks $10.00
7%
Starbucks $25.00
% QTY
Total
Home Improvement Product
% QTY
Total
Ace Hardware $100.00
4%
$
Ace Hardware $25.00
4%
$
Home Depot $100.00
4%
$
Home Depot $25.00
4%
$
Home Depot $500.00
4%
$
Lowe's $100.00
4%
$
Lowe's $1000.00
4%
$
Lowe's $20.00
4%
$
Lowe's $25.00
4%
$
Lowe's $500.00
4%
$
The Home Depot $10.00
4%
$
The Home Depot $100.00
4%
$
ARCO $50.00
1.5%
$
$
BP $50.00
1.5%
$
7%
$
Exxon $50.00
1%
$
Starbucks $5.00
7%
$
Jiffy Lube $30.00
8%
$
SUBWAY® Restaurants $10.00
6%
$
Mobil $50.00
1%
$
$
6%
$
Shell $100.00
2%
$
The Home Depot $1000.00
4%
SUBWAY® Restaurants $50.00
$
2%
$
The Home Depot $25.00
$
5%
Shell $25.00
4%
Taco Bell $10.00 Wendy's $10.00
4%
$
Shell $50.00
2%
$
The Home Depot $500.00
4%
$
Discount Store Product
% QTY
Total
Grocery Product
Total
Albertsons $100.00
4%
$
Albertsons $25.00
4%
$
Whole Foods Market $100.00
3%
$
3%
$
Burlington Coat Factory $25.00
8%
$
Kmart $25.00
4%
$
Kmart $50.00
4%
$
Sam's Club $100.00
2.5%
$
Whole Foods Market $25.00
Sam's Club $25.00
2.5%
$
Health & Beauty
3%
$
Product
Target $10.00
2.5%
Target $100.00
Shopko $25.00
% QTY
% QTY
Online & Catalog Product
% QTY
Amazon.com $10.00
2.5%
$
Total
$
Bath & Body Works $10.00
13%
$
2.5%
$
13%
$
Target $25.00
2.5%
$
Bath & Body Works $25.00 Regis Salons $25.00
8%
$
Target $50.00
2.5%
$
Rite Aid $25.00
4%
$
Page Total
Total
$
Online & Catalog Product
% QTY
Total
Amazon.com $100.00
2.5%
$
Amazon.com $25.00
2.5%
$
Groupon.com $25.00
7%
$
12%
$
Overstock.com $25.00
8%
$
Shutterfly $25.00
4%
$
Nike $25.00
Specialty Retailer Product
% QTY
Total
Babies"R"Us $20.00
3%
$
Build-A-Bear Workshop $25.00
8%
$
Container Store $25.00
9%
$
Jo-Ann Fabric and Craft Stores $25.00
6%
$
Michaels $25.00
4%
$
See's Candies $25.00
9%
$
Tanger Outlets $25.00
8%
$
Toys"R"Us $100.00
3%
$
Toys"R"Us $20.00
3%
$
Sporting Goods Product
% QTY
Total
Bass Pro Shops $25.00
9%
$
Big 5 Sporting Goods $25.00
8%
$
Cabela's $100.00
6%
$
Cabela's $25.00
6%
$
Dick's Sporting Goods $25.00
8%
$
REI $25.00
8%
$
Travel Product
% QTY
Total
Best Western International $100.00
12%
$
Best Western International $25.00
12%
$
Clarion Hotels $100.00
4%
$
Comfort Suites $100.00
4%
$
Comfort Suites $50.00
4%
$
Disney $100.00
3%
$
Disney $1000.00
3%
$
Disney $25.00
3%
$
Quality Inn $100.00
4%
$
Universal Prepaid Cards Product DiscoverÂŽ Universal Gift Card $100.00
% QTY 1.25%
Total $
Page Total
$