PLEASE fill out only one form per family.
Click SHOW TOTALS button at the bottom of the form when done.
NOTE! We are now accepting online payments using our secure web page powered by e.service.
Name:    Phone:    Pick Up in Church Office
Pick Up After Mass this Weekend*
* Weekend pick-up after masses is only available
   if your order is placed by Noon on Friday.
  Credit (if applicable):  
Building Fund Credit? Yes       No  
Tuition Credit? Yes       No  
If Tuition Credit is desired: Child's Name:     
  Program:           AM           PM  
                    3 Yr.    4 Yr.    5 Yr.  
I will pay for the gift cards when I pick up my order.
I would like to pay now with a debit card or a withdrawal from my checking or savings account.**
**You will be directed to a secure site for this purpose when this form successfully completes.
   Want to know how our online payment system works? Click here to find out.
 
BOOK STORES
In-Stock?   Quantity Cost Amount   In-Stock?   Quantity Cost Amount
Yes Barnes & Noble, Doubleday & B Dalton $10   No Family Christian Bookstores $25
Yes Barnes & Noble, Doubleday & B Dalton $25       
CLOTHING AND SHOE STORES
In-Stock?   Quantity Cost Amount   In-Stock?   Quantity Cost Amount
No American Eagle Outfitters
(not for account payment)		 $25   Yes Babies 'R' Us & Toys 'R' Us $20
No Fashion Bug, Catherines & Lane Bryant $25   No GAP, Old Navy & Banana Republic $25
No Payless Shoes $20       
DEPARTMENT STORES
In-Stock?   Quantity Cost Amount   In-Stock?   Quantity Cost Amount
Yes J.C. Penney $25   No K Mart $25
Yes Kohl's - Maximum: 4 cards
(can be used to pay charge or purchase online)		 $25   Yes Marshalls & T.J. Maxx $25
No Sears (never expires) $25   Yes Walmart & Sam's Club $25
ELECTRONICS STORES
In-Stock?   Quantity Cost Amount   In-Stock?   Quantity Cost Amount
Yes Best Buy $25   No Radio Shack $25
ENTERTAINMENT VENUES
In-Stock?   Quantity Cost Amount   In-Stock?   Quantity Cost Amount
Yes Wildwood Highlands $10       
GAS STATIONS
In-Stock?   Quantity Cost Amount   In-Stock?   Quantity Cost Amount
No BP Oil $50   Yes Exxon/Mobil $50
Yes Sheetz $25   No Shell $25
Yes Sunoco $50       
GROCERY STORES
In-Stock?   Quantity Cost Amount   In-Stock?   Quantity Cost Amount
Yes Giant Eagle $10   Yes Shop N Save $25
Yes Giant Eagle $25   Yes Shop N Save $50
Yes Giant Eagle $50       
Yes Giant Eagle $100       
HOME IMPROVEMENT CENTERS
In-Stock?   Quantity Cost Amount   In-Stock?   Quantity Cost Amount
Yes Home Depot $25   Yes Lowe's $25
HOUSEHOLD GOODS
In-Stock?   Quantity Cost Amount   In-Stock?   Quantity Cost Amount
Yes Bed Bath & Beyond $25   No Pier One $25
No Pottery Barn / Williams Sonoma $25       
MISCELLANEOUS
In-Stock?   Quantity Cost Amount   In-Stock?   Quantity Cost Amount
Yes Baskin Robbins $2   Yes Bath & Body Works $10
No Build a Bear $25   Yes Bath & Body Works $25
Yes CVS Pharmacy $25   No GNC $25
No Honeybaked Ham $10   No JoAnn Fabrics $20
No Sally Beauty Supply $25       
OFFICE SUPPLIES
In-Stock?   Quantity Cost Amount   In-Stock?   Quantity Cost Amount
No Office Depot $25   No Office Max $25
No Staples $25       
RESTAURANTS & FAST FOODS
In-Stock?   Quantity Cost Amount   In-Stock?   Quantity Cost Amount
Yes Applebee's $25   Yes Arby's $10
No Bob Evans $10   No Buca Di Beppo $25
Yes Burger King $10   Yes Cheesecake Factory $25
No Cracker Barrel $10   No Damon's $25
No Dave & Buster's $25   No Denny's $10
Yes Eat N Park $10   Yes KFC $5
Yes North Park Lounge Clubhouse $10   Yes Olive Garden / Red Lobster /
Longhorn Steakhouse / Bahama Breeze		 $25
No Outback Steakhouse /
Carrabba's Italian Grill / Bonefish Grill		 $25   Yes Panera Bread $10
No Pizza Hut $10   No Red Robin $25
Yes Starbucks $10   No Subway $10
Yes TGI Friday's $20   Yes Wendy's $10
SPORTING GOODS
In-Stock?   Quantity Cost Amount   In-Stock?   Quantity Cost Amount
No Cabela's $25   Yes Dick's Sporting Goods $25
No Gander Mountain $25