Customer Information Name           CC #             Date        
                                   
Through School Student Name       Room # Exp.     Address       Zip        
                                   
            Signature                      
Always in Stock !       Always in Stock !         Always in Stock !      
Store Profit Value # Pmt. R Store Profit Value # Pmt. R   Store Profit Value # Pmt. R
American Eagle 9% $25       Home Depot 3% $25         Starbucks 7% $10      
Applebee’s 8% $25       Home Depot 3% $100         Starbucks 7% $25      
Arby’s 8% $10       Honey Baked Ham 12% $10         Subway 3% $10      
Auntie Anne’s  8% $10       JC Penney 5% $25         Supreme Nut & Candy 10% $5      
Barnes & Noble 9% $10       Joe’s Crab Shack 12% $25         Texas Roadhouse 8% $25      
Bass Pro Shop 7% $25       Johnny’s Toys 10% $20         Wendy's 4% $10      
Bath & Body Works 18% $10       KFC 9% $5                    
Bath & Body Works 18% $25       Kohl’s (use on acct) 5% $25                    
Bed, Bath & Beyond 7% $25       Kohl’s (use on acct) 5% $50         Special Orders we can get in      
Bigg's 6% $50       Kroger’s Rechargeable 4% $1         Buca di Beppo 8% $25      
Blockbuster 1 x rental 15% $4       Kroger’s Rechargeable 4% $10         Circuit City 3% $50      
Blockbuster 7% $10       Long John Silvers 9% $5