SAINT VALENTINE SCRIP ORDER FORMRevised: 6-11-2026OFFICE USE ONLY:
       DATE ENTERED: __________

ACCOUNT BALANCE: __________
Name:
Date:Phone:
I will pick this order up at St. Valentine   School   Rectory

Send this order home with my child _______________ in grade _______

StoreQtyTotal
Ace Hardware ($25)4%          $            
Ace Hardware ($100)4%          $            
Advance Auto Parts ($25)7%          $            
Aeropostale ($25)7%          $            
Amazon.com ($25)4%          $            
Amazon.com ($100)4%          $            
AMC single movie ($9.50)16%          $            
AMC Theatres/Loews Cinepl ($25)7%          $            
American Airlines ($250) ($100)8%          $            
American Eagle Outfitters ($25)10%          $            
Applebee's ($25)8%          $            
Applebee's ($50)8%          $            
Arby's ($10)8%          $            
AT&T 120 Min Card ($9.50)20%          $            
Autozone ($25)8%          $            
Avis Rent A Car ($50)8%          $            
BajaFresh ($25)7%          $            
Barnes&Noble/B.Dalton ($10)9%          $            
Barnes&Noble/B.Dalton ($25)9%          $            
Barnes&Noble/B.Dalton ($100)9%          $            
Baskin Robbins ($2)9%          $            
Bass Pro Shops($100) ($25)14%          $            
Bath & Body Works ($10)13%          $            
Bath & Body Works ($25)13%          $            
BD Mongolian BBQ ($20)8%          $            
Bed Bath & Beyond ($25)7%          $            
Bed Bath & Beyond ($100)7%          $            
BedandBreakfast.com ($50)10%          $            
Best Buy Card ($25)3%          $            
Best Buy Card ($100)3%          $            
Best Buy Card ($250)3%          $            
Best Western Hotel ($100)12%          $            
Bob Evans ($10)10%          $            
BoRics ($25)10%          $            
Boston Market ($10)12%          $            
BP Gas ($50)1%          $            
BP Gas ($100)1%          $            
BP Gas ($250)3%          $            
Brann's ($10)9%          $            
Bravo! Cucina Italiano ($25)12%          $            
Bruegger's Bagels ($10)7%          $            
Buca di Beppo ($25)8%          $            
Budget Rent A Car ($50)8%          $            
Buffalo Wild Wings ($25)8%          $            
Build a Bear ($25)8%          $            
Burger King ($10)4%          $            
StoreQtyTotal
Burlington Coat Factory ($25)8%          $            
Cabela's ($25)11%          $            
Cabela's ($100)11%          $            
California Pizza Kitchen ($10)4%          $            
Cascading Card File ($2.96)25%          $            
Celebration Cinema ($10)4%          $            
Champps ($25)8%          $            
Chevron ($50)1%          $            
Chevron($250) ($100)1%          $            
Chevy's Fresh Mex ($25)8%          $            
Children's Place ($25)12%          $            
Children's Place ($25)12%          $            
Chili's ($25)11%          $            
Chipotle ($10)10%          $            
Chuck E. Cheese ($10)8%          $            
Cinemark ($25)4%          $            
Circle K ($25)1%          $            
Claire's ($10)9%          $            
Cold Stone Creamery ($10)8%          $            
Comfort Inn ($100) ($25)4%          $            
Cracker Barrel ($10)9%          $            
Cracker Barrel ($25)9%          $            
Crate & Barrel ($25)8%          $            
Crazy 8 ($25)13%          $            
CVS ($25)6%          $            
CVS ($100)6%          $            
Dave & Busters ($25)13%          $            
Dell ($100)4%          $            
Denny's ($10)7%          $            
Dicks Sporting Goods ($100)8%          $            
Dick's Sporting Goods ($25)8%          $            
Disney Gift Card ($1,000)2%          $            
Disney Gift Card($100) ($25)2%          $            
Domino's Pizza ($10)8%          $            
Dress Barn ($25)8%          $            
DSW-Shoe Warehouse ($25)9%          $            
Dunhams ($25)8%          $            
Dunkin' Donuts ($10)4%          $            
Eddie Bauer ($25)10%          $            
Einstein Bros. Bagels ($10)10%          $            
Express ($25)10%          $            
Exxon/Mobil ($50)1%          $            
Exxon/Mobil ($250)1%          $            
Family Fare/Glen's ($25)2%          $            
Family Video ($10)12%          $            
Fannie May ($10)25%          $            
StoreQtyTotal
Fashion Bug ($25)6%          $            
Finish Line ($25)10%          $            
Fire Mountain ($25)5%          $            
Footlocker Stores ($25)9%          $            
Game Stop ($25)3%          $            
Gander Mountain ($25)8%          $            
Gap/OldNvy/BanRep ($25)14%          $            
Giant Eagle ($100)4%          $            
Gift Card Wrappers -16 ($2)10%          $            
GNC ($25)8%          $            
Golfsmith ($25)8%          $            
Gordon Food Service ($25)4%          $            
Gordon Food Service ($100)4%          $            
Great Clips ($25)8%          $            
Great Harvest Bread ($10)6%          $            
Guitar Center ($25)4%          $            
Gymboree ($25)13%          $            
Hallmark ($25)4%          $            
Hard Rock Cafe ($25)10%          $            
Harry & David ($25)10%          $            
Home Depot ($25)4%          $            
Home Depot ($100)4%          $            
Home Depot ($500)4%          $            
Home Depot ($1,000)4%          $            
Honey Baked Ham ($25)12%          $            
Hyatt Hotels ($50)9%          $            
Hyatt Hotels ($100)9%          $            
IHOP ($25)8%          $            
I-tunes ($15)5%          $            
I-tunes ($25)5%          $            
J Crew ($25)13%          $            
J. Jill ($25)8%          $            
JCPenney Card ($25)5%          $            
JCPenney Card ($100)5%          $            
Joann Fabrics ($25)6%          $            
Journeys ($25)10%          $            
K Mart Cash Card ($25)4%          $            
K Mart Cash Card ($50)4%          $            
Kentucky Fried Chicken ($5)8%          $            
Kohl's ($25)4%          $            
Kohl's ($100)4%          $            
L.L. Bean ($25)15%          $            
L.L. Bean ($100)15%          $            
Landry's/Charley's Crab ($25)9%          $            
Landry's/Charley's Crab ($100)9%          $            
Land's End ($25)16%          $            

 

StoreQtyTotal
Land's End ($100)16%          $            
Limited ($25)9%          $            
Little Caesars ($20)8%          $            
Logan's Roadhouse ($25)8%          $            
Longhorn Steakhouse ($25)9%          $            
Lord & Taylor ($25)8%          $            
Lowe's Prepaid Card ($25)4%          $            
Lowe's Prepaid Card ($100)4%          $            
Lowe's Prepaid Card ($500)4%          $            
Macy's ($25)10%          $            
Macy's ($100)10%          $            
Mainstreet Restaurants ($25)12%          $            
Marathon ($25)3%          $            
Marathon ($100)3%          $            
Marathon ($250)4%          $            
Marriott Hotels ($50)8%          $            
Marriott Hotels ($100)8%          $            
MC Sports Card ($25)8%          $            
Meijer ($25)3%          $            
Meijer ($100)3%          $            
Men's Warehouse ($25)8%          $            
Michaels ($25)4%          $            
Motherhood Maternity ($25)8%          $            
Neiman Marcus ($50)12%          $            
Nike ($25)12%          $            
Noodles Company ($10)8%          $            
Nutrisystem ($50)12%          $            
OCharleys ($25)13%          $            
Office Depot ($25)4%          $            
Office Depot ($100)4%          $            
Office Max ($25)5%          $            
Office Max ($100)5%          $            
Old Country Buffet ($25)5%          $            
Olga's Kitchen ($20)8%          $            
Outback Steakhouse ($25)8%          $            
Overstock.com ($25)8%          $            
P.F. Chang ($25)8%          $            
Panera ($10)9%          $            
Panera ($25)9%          $            
StoreQtyTotal
Papa John's ($10)8%          $            
Parisian/BonTon ($25)8%          $            
Payless Shoes ($20)13%          $            
PepBoys ($20)4%          $            
PetsMart ($25)4%          $            
Pier One Imports Card ($25)9%          $            
Pizza Hut Card ($10)8%          $            
PotteryBarn/WilliamSonoma ($25)8%          $            
Qdoba ($25)7%          $            
Quiznos ($10)10%          $            
Radio Shack ($25)4%          $            
Red Robin ($25)11%          $            
RedLbstr/OlvGrdn/BhmaBrz ($25)9%          $            
Regis Salon ($25)8%          $            
REI ($25)8%          $            
Restaurant.com ($20)50%          $            
Restoration Hardware ($25)12%          $            
Rite Aid ($25)4%          $            
Ritz-Carlton Hotels ($50)8%          $            
RnfstCafe/C.Muer/Lndry's ($25)9%          $            
Rocky Mt. Chocolate ($10)11%          $            
Ross Dress for Less ($25)8%          $            
Ruby Tuesday's ($25)8%          $            
Sally Beauty Co ($25)12%          $            
Sears Debit Card ($25)4%          $            
Sears Debit Card ($100)4%          $            
Sears Debit Card ($250)4%          $            
See's Candies ($16.50)20%          $            
See's Candies ($16.50)20%          $            
See's Candies ($16.50)20%          $            
Sephora ($20)4%          $            
Shell Prepaid Gas Card ($25)3%          $            
Shell Prepaid Gas Card ($50)3%          $            
Shell Prepaid Gas Card ($100)3%          $            
Shutterfly ($25)9%          $            
Spa Finder ($25)12%          $            
Speedway/Total Card ($25)4%          $            
Speedway/Total Card ($100)4%          $            
Sports Authority ($25)8%          $            
StoreQtyTotal
Sports Authority ($100)8%          $            
Staples ($25)5%          $            
Starbucks ($10)7%          $            
Starbucks ($25)7%          $            
Steak-n-Shake ($10)8%          $            
Subway ($10)3%          $            
Sunoco Card ($50)1%          $            
Sunoco Card ($250)3%          $            
Supercuts ($25)8%          $            
T.J.Maxx/Marshall's ($25)7%          $            
T.J.Maxx/Marshall's ($100)7%          $            
Taco Bell ($10)5%          $            
Talbots ($25)13%          $            
Tanger Outlet ($25)8%          $            
Target ($25)2%          $            
Target ($100)2%          $            
Texas Roadhouse ($25)8%          $            
TGI Friday's ($25)9%          $            
The Body Shop ($25)8%          $            
The Children's Place ($25)12%          $            
The Children's Place ($25)12%          $            
Tim Hortons ($10)5%          $            
Township Hardware ($1)10%          $            
Toys-R-Us ($20)1%          $            
Uno's Pizza ($25)11%          $            
Value Center ($100)5%          $            
Walgreens ($25)6%          $            
Walgreens ($100)6%          $            
Walmart/SAM'S ($25)2%          $            
Walmart/SAM'S ($100)2%          $            
Wendy's ($10)4%          $            
Westborn Market ($1)5%          $            
Wet Seal ($25)5%          $            
Whole Foods ($25)3%          $            
Whole foods ($100)3%          $            
Zappo's.com ($25)8%          $            

 

ORDER TOTAL: _______________________    Make check payable to ST. VALENTINE SCHOOL
NOTES: DOUBLE CHECK YOUR CALCULATIONS! If your payment does not match the amount due your order may still be processed, and may result in an increase or decrease of your balance. The deadline for new orders is 11 am on Monday. Orders can be picked up Friday noon. For a complete list of current retailers and policies, visit www.glscrip.com. Use blank lines to order certificates not listed here.