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Order Form

The document is a scrip order form for Clyde Hamrick School's PTO scrip program. It requests basic contact and student information from participants. It explains that orders are due on Mondays and will be processed and available for pickup the following Friday. Checks should be made payable to the Clyde Hamrick PTO and enclosed with the completed order form. The order form includes a list of participating merchants with their rebate percentage and space to list quantities and calculate totals. It provides contact information for the scrip coordinator and notes the program helps support the school.

Uploaded by

HuskiePTO
Copyright
© Attribution Non-Commercial (BY-NC)
Available Formats
Download as XLS, PDF, TXT or read online on Scribd
129 views

Order Form

The document is a scrip order form for Clyde Hamrick School's PTO scrip program. It requests basic contact and student information from participants. It explains that orders are due on Mondays and will be processed and available for pickup the following Friday. Checks should be made payable to the Clyde Hamrick PTO and enclosed with the completed order form. The order form includes a list of participating merchants with their rebate percentage and space to list quantities and calculate totals. It provides contact information for the scrip coordinator and notes the program helps support the school.

Uploaded by

HuskiePTO
Copyright
© Attribution Non-Commercial (BY-NC)
Available Formats
Download as XLS, PDF, TXT or read online on Scribd
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Clyde Hamrick Scrip Order Form - Help Support

Our School!!

Name:________________________________________

Phone #1: _____________________________________ Orders Accepted Anytime!


Phone #2: _____________________________________ Orders will be processed the first Monday after being
received. Please look for confirmation sticker in your
Child's Name: __________________________________ child's binder after this day!
Child's Teacher: ________________________________ Orders should be in on that Friday.
Order/pickup days are subject to change.
Please make checks payable to Clyde Hamrick PTO & enclose with order form in a sealed envelope marked 'Scrip'. All
orders must be paid in advance & all sales final. Hamrick PTO not responsible for lost/stolen orders. Questions?
Please call Jeanine Sarver, Scrip Coordinator
(636) 346 – 6114 [email protected]
Orders may also be placed online at www.shopwithscrip.com The enrollment code is: AABFE75927193

Front Total Office Use Only

Back Total Check # Amt Pd Date Initial

Total

If you would like your order sent home with your child, please If you would like to pick up your order on that Friday
sign here. Remember, Scrip is just like cash! from the office, please sign here.

X X
Merchant % Value Qty Total Merchant % Value Qty Total
Accessories
Gift Card Pocket Holder 25% $3.00
Gift Card Wrappers 20% $5.60
Restaurants
Applebee's
Arby's
Bob Evans
Burger King
Casa Gallardo
Chevy's Fresh Mex
Chili's / Macaroni Grill
Chuck E Cheese
Cold Stone Creamery
Cracker Barrel
Culvers
Dave and Buster's
Denny's
Comino's
Fazoli's
Hard Rock Café
Harry & David

Honey Baked Ham


Total Front Page

Orders are due by 9:00 am on Mondays. Scrip is a PTO sponsored program.


Orders filled on Fridays.
5/11
40 Sams/Wal Mart 25 1000
41 Panera 10 410
33 Red Lobster/Olive $25 825
23 Shop n Save 25 575
20 Cracker Barrel 10 200
19 Kohls 25 475
18 Steak & Shake $10 180

194 3665

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