eSCRIP: Order Form


Below is the new SCRIP menu for the 2007-08 school year. You may place your online order at any time! (Once your order is placed, it will be available for pick up in the location that you selected.)

What is SCRIP? (and other details)

Printable Copy of SCRIP Menu (PDF file)

Please follow these steps when placing your eSCRIP order:

  1. Type the necessary personal information in the first section.
  2. Type the desired quantity next to the denominations you want for the stores of your choice.
  3. Type the total of your purchase - you will need to figure the total on your own. (Clicking "Reset" will clear your entries and allow you to start over.)
  4. Select your pick up location.
  5. Click the "Submit" button at the bottom of the page. The order form will be replaced with a "Thank You" page when you submit the order.
  6. Submit your payment when you pick up your order.
    Name
    Phone Number
    E-Mail

    Grocery Stores
    Albertson's (4%) 25 100 -
    Fred Meyer (5%)
    10
    25
    100
    Safeway (4%) 25 100 -
    Summit Trading (7%)
    25
    100
    -
    Top Foods (10%)
    50
    -100
    -
    Gas Stations
    Arco (2%) 50 - -
    Chevron (2%) 50 - -
    Shell (1.5%)
    25
    -100
    -
    Fast Food & Restaurants
    Applebee's (8%) 25 - -
    Arby's (10%) 10 - -
    Aversano's (8%) 25 - -
    Baskin Robbins (9%)
    2
    -
    -
    Black Angus (14%)
    20
     
    -
    Burger King (4%)
    10
    -
    -
    Cheesecake Factory (5%) 25 - -
    Coldstone Creamery (8%) 10 - -
    Denny's Restaurant (7%) 10 - -
    Dixie's Home Cookin' (8%) 10 20 -
    Jack in the Box (4%) 15 - -
    Jamba Juice (7%) 10 - -
    Johnny Rockets (8%) 20 - -
    KFC (9%)
    5
    -
    -
    McDonalds (3%) 15 - -
    Old Country Buffet (5%) 25 - -
    Olive Garden / Red Lobster (9%)
    25
    --
    -
    Outback (4%)
    25
    -
    -
    Panera Bread (9%) 10 - -
    Pizza Hut (9%)
    10
    -
    -
    Puerto Vallarta (7%)
    		 25 - -
    Red Robin (9%)
    10
    -
    -
    Stanley & Seafort's and
    Palisades restaurants (20%)    		 50 - -
    Starbucks (7%)
    5
    10
    25
    Subway (3%) 10 - -
    TGI Friday's (8%)
    25
    -
    -
    Wendy's (4%)
    10
    -
    -
    Retail Stores
    American Eagle (8%) 25 - -
    Barnes & Noble / B. Dalton (9%)
    10
    25
    -
    Bath & Body Works (13%)
    10
    25
    -
    Bed, Bath & Beyond (7%) 25 - -
    Benton's Twin Cedar Florist (15%) 25 - -
    Best Buy (2%)
    25
    -
    Blockbuster Video (7%)
    10
    -
    -
    Border's / Waldenbooks (9%)
    10
    -25
    -
    Build-a-Bear (8%) 25 - -
    Cabela's (11%) 25 -100 -
    Circuit City (3%) 25 100 -
    Claire’s (9%)
    10
    -
    -
    Dr. Crouch Orthodontics (5%) 100 - -
    Family Christian Book (9%) 10 - -
    Home Depot (3%)
    25
    100
    500
    iTunes (4%) 15 - -
    JC Penney (5%)
    25
    100
    -
    JoAnn Fabrics (6%) 20 - -
    Kohl's (4%) 25 - -
    Linens n' Things (8%) 25 - -
    Lowe's (4%)
    25
    100
    500
    Macy's (10%)
    25
    -100
    -
    Marie Sauers Massage Therapy (10%) 50 - -
    Old Navy / Gap / Banana Republic (9%)
    25
    - -
    -
    Pampered Chef (10%) 25 - -
    Pier One (9%) 25 - -
    Regal Theaters / Edward’s (8%)
    25
    Regis Hair (all Regis brands) (8%) 25 - -
    Rite Aid (4%) 25 - -
    Sears / K-mart (4%)
    25
    100
    -250
    See's Candy (21%)
    14
    -
    -
    Sports Authority / Gart Sports (8%) 25 - -
    TJ Maxx / Marshall's (7%)
    25
    -
    Toys R Us (3%) 25 - -
    Uniform Store (6%)
    20
    -
    -
    Walgreen's (2%) 20 100 -
    Wal-Mart (2%) 25 100 -
    Williams-Sonoma / Pottery Barn (8%)
    25
    -
    -

    Total

    Pick-up Location: