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聖迦谷羅省基督教會 FECSGV

Church Development Fund SCRIP Program

Order Form Please make check payable to : FECSGV

姓名 ﹝Name﹞_________________________ MERCHANT(% Rebate) DENOMINATION TOTAL


電話﹝Phone #﹞_______________________ 廠商名稱 面額 總額
□國 □粵 □English DINING/ FAST FOOD
團契﹝Fellowship﹞______________________ Applebee’s (8%) $ 25 _________

Baskin Robbins (9%) $ 2 _________


MERCHANT(% Rebate) DENOMINATION TOTAL
廠商名稱 面額 總額 Burger King (4%) $ 10 _________
99 Ranch Market(6 %) $ 10 ________ Carl’s Jr. (9%) $ 10 __________
大華超市 $ 20 ________
Cheesecake Factory (5%) $ 25 _________
Hongkong Supermarket (6%) $ 20 _________
香港超市 Chili’s/Macaroni Grill (11%) $ 25 _________
Arcadia Supermarket (5%) $ 25 _________ Claim Jumper (8%) $ 25 _________
光華超市 $ 50 _________
COCO (17%) $ 10 _________
GROCERY STORES
Albertson’s (4%) $ 25 _________ Denny’s (9%) $ 10 _________
$ 100 _________
Hometown Buffet (5%) $ 25 _________
Safeway/VONS/Pavilion(4%) $ 25 _________
$ 100 _________ Jamba juice (7%) $ 10 _________
Wal Mart/ Sam’s Club (2%) $ 25 __________ Marie Callender’s (18%)
$ 100 ____ $250 _____ $ 25 _________

GASOLINE Olive Garden/Red Lobster(9%) $ 25 __________


ARCO Gas (2%) $ 50 _________ Pizza Hut (9%) $ 10 __________
Chevron (2%) $ 50 ________ Souplantation (8%) $ 10 __________
$ 100 ________
Starbucks (7%) $ 10 _________
Mobile (2%) $ 50 ____ 250 ____
$ 25 __________
Shell (1.5%) $ 25 ___ 50 _____
See’s Candies( 25%) $ 15 __________
$ 100 __________

DRUG STORES Subway (3%) $ 10 __________


CVS Pharmacy (6% ) $ 25 ___________

Rite Aid (4%) $ 25 _________


ENTERTAINMENT
Walgreens (2%) $ 20 _________
AMC single ticket (16%) $ 9.50 _________
BOOKS/ONLINE & MAIL ORDER
AMC Theatres (7%) $ 25 __________
Amazon.com (4%) $ 25 _________
$ 100 _________ Blockbuster single video rental $ 3.79 _______
Barnes & Noble Bookstores (15%)
$ 10 ___________
(9%) $ 25 ____________ Blockbuster gift card (7%) $ 10 ________
$ 100 ___________
Regal Entertainment (8%) $ 25 __________
Borders (9%) $ 10 ________
$ 25 ________ Regal Single Movie ticket(16%) $ 9 __________
iTunes (4%) $ 15 __________