Support our school!

ORDERING SCHEDULE
Payment & Order DUE
Wednesday 5/27/2015

Cards Distributed
Wednesday 6/3/2015

Next BRONCO BUCKS orders are DUE Wednesday May 27th. Because of IEs awesome support of the program,
we were able to fund our Winter Carnival and raise $$$ for our beautiful new Computer Lab - THANK YOU!!!
Together we have ordered over $32,000 in gift cards and raised over $1,600 for our school computer lab
(average rebate 5.1%)!
This is a GREAT resource for any End of the Year gifts you may need.save yourself the time and hassle of
running around to different stores. Everyone loves a gift card!
Dont forget to take advantage of HIGH rebate offers like Athleta (14%), Bath & Body Works (13%), Chipotle
(10%), Barnes & Noble (9%), Gap and Old Navy (14%), AMC Theaters (10%), Einstein Bagels (10%) and MANY
others that offer rebates of 10%+!
Thank you in advance for your support!

Independence Elementary PTO

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BRONCO BUCKS ORDERING

** Attached Enrollment Form must be completed in conjunction with first order being placed **
Questions/Contact: Sarah Malys (248-210-8164 / sarahmalys@comcast.net)

SHOP ON-LINE (PREFERRED METHOD) ** Easiest and Fastest! **

1.

Create your Family Account at www.shopwithscrip.com ( Enrollment Code L89CL61A4LL58)

2.

Click on Shop in the upper right to view hundreds of gift cards options. For many retailers you may choose
between a physical gift card (to be distributed approximately one week after order is due) OR a ScripNow option
which allows for much quicker turnaround and the ability to print out directly from your computer.

3.

Two options for payment:

1) Set up PrestoPay via the website. This process takes 2-3 days to complete, however once your bank
account is verified, you may pay for your order directly on-line.
OR
2) Pay via check payable to Independence Elementary PTO. Payment MUST be received by specified due
date on ordering schedule. Please submit in an envelope labeled Scrips Order to your childs teacher.

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If you are unable to shop via the website, you may complete the attached Family Order Form and return with check
payment (payable to Independence Elementary PTO) by specified deadline. Please submit in an envelope labeled
Scrips Order to your childs teacher.
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Card Distribution: Physical gift cards will be distributed approximately one week after money is due. Please note if you
would like your card sent home with your child OR held for you in the school office. Attached Waiver of Responsibility
must be signed and returned if you would like the cards sent home with your child.

Enrollment Form
Independence Elementary PTO Scrips Program (Bronco Bucks)
PROGRAM RULES AND GUIDELINES: Please read carefully before completing the form.
** Must be completed and returned to Bronco Bucks Coordinator in conjunction with first order **
1.
All orders must be accompanied by cash, check or money order made payable to Independence Elementary
PTO. Scrip purchases are not tax deductible because you receive dollar of dollar value.
2.
If your check is returned because of non-sufficient funds (NSF) you will be charged a $30 fee payable to
Independence Elementary PTO. After 2 NSF checks are tendered on your account, your scrip privileges will be limited
to cash or money order only.
3.
Scrip certificates are purchased on your behalf and are not returnable.
4.
When you receive your certificates, open your order and verify its accuracy. In the unlikely event you should
find a discrepancy in your order, please contact one of the scrip coordinators immediately.
5.
Scrip certificates are the same as cash and should be handled accordingly. Independence Elementary PTO will
not be responsible for certificates that are lost, stolen or misplaced once given to your child.
6.
You must sign the Waiver of Responsibility section of this form before certificates will be released to your
child. Independence Elementary PTO accepts no responsibility for certificates delivered in this manner. Otherwise,
your certificates may be picked up in the school office.

Name (first and last): _______________________________

Address: ____________________________________________
E-Mail: ____________________________________________
Phone Number: _______________(home) _______________(cell)
I have read and understand the policies and guidelines listed above, and I agree to abide by these policies.
Signature:________________________________Date:____________________

*********************************************************************
Waiver of Responsibility
The following waiver of responsibility will allow us to send your SCRIP order home with your child. Please complete the
waiver form if you elect this option and return it to school. If you do NOT have a waiver on file, your SCRIP order can be
picked up in the school office.
WAIVER OF RESPONSIBILITY
I hereby grant my permission for the Independence Elementary PTO to send my order of SCRIP certificates home with
my child_________________________ in _________________s classroom. I understand that I accept full
responsibility for the certificates and that the Independence Elementary PTO, Independence Elementary School and
the Clarkston School District have NO responsibility for the certificates once they are delivered to my child. This
permission shall remain in effect for the 2014-2015 school year or until I provide written notice to rescind it.
Print name:_________________________________________
Address:____________________________________________
Home phone:______________________Work phone:___________________
Signature:________________________________Date:____________________

Created: 5/4/2015 4:18:13 PM

Family Order Form

Independence Elementary PTO

Order form and check payment DUE by Fri WED 5/27/15 (pickup by 6/3/15). Please note if you would like your card sent home (note
child's name and teacher) OR held in the school office. Hundreds more on-line!
Name

Customer #

Check #

Order Date

Product

Total

Product

Total

Product

1-800-Flowers $50.00

12%

% QTY

Burlington Coat Factory

$25.00

8%

Express $25.00

Ace Hardware $25.00

4%

Buy Buy Baby $25.00

7%

adidas $25.00

13%

11%

Aeropostale $25.00

10%

3%

California Pizza Kitchen

$25.00

8%

Amazon.com $10.00
Amazon.com $25.00

3%

Caribou Coffee $10.00

6%

AMC Theatres $10.00

8%

Carrabba's Italian Grill

$25.00

8%

AMC Theatres $25.00

8%

Carson's $25.00

8%

American Girl $25.00

9%

Children's Place $25.00

12%

Applebee's $10.00

8%

Chili's Grill & Bar $25.00

11%

Applebee's $25.00

8%

Chipotle Mexican Grill

$10.00

10%

Arby's $10.00

8%

Athleta $25.00

14%

Babies"R"Us $20.00

3%

Cabela's $25.00

% QTY

Chuck E. Cheese
$10.00

8%

Claire's $10.00

9%

8%

Baja Fresh $25.00

7%

Cold Stone Creamery

$10.00

Banana Republic
$25.00

14%

Comfort Inn $50.00

4%

Country Buffet $25.00

5%

Cracker Barrel $25.00

9%

Crate and Barrel $25.00

8%

13%

Barnes & Noble $10.00

Bass Pro Shops $25.00

9%
9%

$
$

1%

Family Video $10.00

12%

Fleming's Prime
Steakhouse $25.00

8%

Foot Locker $25.00

9%

GameStop $25.00

3%

Gander Mountain
$25.00

8%

14%

GFS Marketplace
$25.00

4%

GNC $25.00

8%

Golfsmith $25.00

8%

Great Clips $25.00

8%

Great Harvest Bread

$10.00

6%

Groupon.com $25.00

7%

Guitar Center $25.00

4%

Gymboree $25.00

13%

Hallmark $25.00

4%

Hard Rock Cafe $25.00

10%

Harry & David $25.00

10%

HomeGoods $25.00

7%

Honey Baked Ham

$25.00

12%

IHOP $25.00

8%

iTunes $15.00

5%

J. Crew $25.00

13%

jcpenney $25.00

5%

Jo-Ann Fabric and Craft

Stores $25.00

6%

10%

KFC $5.00

8%

4%

Exxon $50.00

Gap $25.00

13%

bd's Mongolian Grill

$20.00

8%

CVS/pharmacy $100.00

6%

Bed Bath & Beyond

$25.00

7%

Dairy Queen $10.00

3%

Best Buy $25.00

3%

Dave & Buster's $25.00

13%

Bonefish Grill $25.00

8%

Dell Computer $100.00

4%

BoRics $25.00

8%

Denny's $10.00

7%

Boston Market $10.00

12%

Destination Maternity
$25.00

8%

BP $50.00

1.5%

Dick's Sporting Goods

$25.00

8%

Bravo Cucina Italiana

$25.00

12%

Dillard's $25.00

9%

Brio Tuscan Grille

$25.00

12%

Discover Universal
Gift Card $100.00

1.25%

8%

Disney $25.00

2%

Kmart $25.00

8%

Kohl's $25.00

Crazy 8 $25.00

Journeys $25.00

Buckle $25.00

8%

Domino's Pizza $10.00

Buffalo Wild Wings

$25.00

8%

Dunham's Sports
$25.00

8%

L.L.Bean $25.00

Build-A-Bear Workshop
$25.00

8%

Dunkin' Donuts $10.00

3%

Burger King $10.00

4%

Einstein Bros. Bagels

$10.00

10%

Make Checks Payable To:

Independence Elementary PTO

Total
$

Bath & Body Works

$10.00

Buca di Beppo $25.00

% QTY
10%

4%

16%

Land of Nod $25.00

8%

Lands' End $25.00

16%

9%

Limited $25.00

Total Due All Columns:

Created: 5/4/2015 4:18:13 PM

Family Order Form

Independence Elementary PTO

Order form and check payment DUE by Fri WED 5/27/15 (pickup by 6/3/15). Please note if you would like your card sent home (note
child's name and teacher) OR held in the school office. Hundreds more on-line!
Name

Customer #

Check #

Order Date

Product

Total

Product

Total

Product

Little Caesar's Pizza

$20.00

8%

% QTY

Plum Market $50.00

3%

% QTY

The Home Depot

$25.00

4%

% QTY

Total
$

Lord & Taylor $25.00

8%

Pottery Barn $25.00

8%

Tim Hortons $10.00

5%

7%

Toys"R"Us $20.00

3%

4%

Qdoba Mexican Grill

$25.00

Macaroni Grill $25.00

11%

Rainforest Cafe $25.00

9%

ULTA $25.00

4%

Maggiano's Little Italy

$25.00

11%

Red Lobster $25.00

9%

Under Armour $25.00

11%

Marathon $25.00

3%

Red Robin $25.00

9%

Uno Pizzeria & Grill

$25.00

12%

Marshalls $25.00

7%

REI $25.00

8%

Walgreens $25.00

6%

Restaurant.com $20.00

50%

Walmart $25.00

2.5%

Restoration Hardware
$25.00

12%

Wendy's $10.00

4%

Rite Aid $25.00

4%

West Elm $25.00

8%

Ruby Tuesday $25.00

8%

Whole Foods Market

$25.00

3%

10%

Williams-Sonoma
$25.00

8%

4%

Younkers $25.00

8%

Sally Beauty Supply

$25.00

12%

Zappos.com $25.00

8%

Sam's Club $25.00

2.5%

Lowe's $25.00

McCormick & Schmick's

$25.00

9%

Meijer (not AK and HI)

$100.00

3%

Meijer (not AK and HI)

$25.00

3%

Michaels $25.00

4%

Mobil $50.00

1%

Morton's Steakhouse
$25.00

9%

Motherhood Maternity
$25.00

8%

Muer Seafood $25.00

9%

Sears $25.00

4%

12%

Sephora $20.00

5%

Noodles & Company

$10.00

8%

Shell $25.00

2.5%

Office Max $25.00

5%

Shutterfly $25.00

9%

14%

Speedway $25.00

4%

8%

Nike $25.00

Old Navy $25.00

Ruth's Chris Steak

House $50.00
Safeway $25.00

Olive Garden $25.00

9%

Sports Authority $25.00

On The Border $25.00

11%

Staples $25.00

5%

Oriental Trading
Company $25.00

9%

Star Theatres $25.00

8%

Starbucks $10.00

7%

Outback Steakhouse
$25.00

8%

$
Steak 'n Shake $10.00

8%

Overstock.com $25.00

8%

6%

P.F. Chang's China

Bistro $25.00

8%

SUBWAY Restaurants
$10.00
Sunglass Hut $25.00

12%

Panera Bread $10.00

9%

Sunoco $50.00

1.5%

Papa John's Pizza

$10.00

8%

7%

13%

T.J.
Maxx/Marshalls/HomeG
oods $25.00

Pei Wei Asian Diner

$25.00

8%

Taco Bell $10.00

5%

Tanger Outlets $25.00

8%

PetSmart $25.00

4%

2.5%

Pier 1 Imports $25.00

9%

9%

Pizza Hut (Not AK or HI)

$10.00

8%

Payless Shoes $20.00

Make Checks Payable To:

Target $25.00
TGI Fridays $25.00

Independence Elementary PTO

Total Due All Columns: