ORDER FORM
Complete this WORD form on your computer; print it and hand it in at the Gift Card table or to the office
|
|
Name:
|
|
Telephone:
|
|
|
Email:
|
|
Date:
|
|
Paid by:
|
Cash
|
|
Cheque
|
|
Debit
|
|
Visa
|
|
MC
|
|
|
|
|
|
|
OTY
|
DEN
|
%
|
TOTAL
|
American Eagle, Aerie, 77kids
|
|
25.00
|
5.0%
|
|
Bass Pro Shops
|
|
50.00
|
7.0%
|
|
Bath & Body Works
|
|
25.00
|
7.0%
|
|
Best Buy
|
|
25.00
|
1.5%
|
|
Best Buy
|
|
100.00
|
1.5%
|
|
The Body Shop
|
|
25.00
|
7.0%
|
|
Boston Pizza
|
|
25.00
|
7.0%
|
|
Canadian Tire - Canadian Tire Gas Bar
|
|
25.00
|
4.0%
|
|
Canadian Tire - Canadian Tire Gas Bar
|
|
50.00
|
4.0%
|
|
Canadian Tire - Canadian Tire Gas Bar
|
|
100.00
|
4.0%
|
|
Cara - Swiss Chalet, Kelsey's, Harvey's, Montana's, Milestones, Coza Tuscan
|
|
25.00
|
4.0%
|
|
Cara - Swiss Chalet, Kelsey's, Harvey's, Montana's, Milestones, Coza Tuscan
|
|
50.00
|
4.0%
|
|
Chapter's, Indigo, Coles, World's Biggest Book Store
|
|
10.00
|
10.0%
|
|
Chapter's, Indigo, Coles, World's Biggest Book Store
|
|
25.00
|
10.0%
|
|
The Children's Place
|
|
25.00
|
9.0%
|
|
Cineplex, Galaxy, Famous, Coliseum, SilverCity, Colossus, Paramount Admit One
|
|
10.00
|
6.5%
|
|
Cineplex, Galaxy, Famous, Coliseum, SilverCity, Colossus, Paramount Child's Night Out
|
|
13.50
|
8.0%
|
|
Cineplex Gift Card
|
|
25.00
|
4.0%
|
|
Earls Restaurants
|
|
25.00
|
7.0%
|
|
Esso, On The Run
|
|
25.00
|
2.5%
|
|
Esso, On The Run
|
|
50.00
|
2.5%
|
|
Esso, On The Run
|
|
100.00
|
2.5%
|
|
Fairmont Hotels
|
|
50.00
|
10.0%
|
|
The Gap, Gap Kids, Baby Gap, Old Navy, Banana Republic
|
|
25.00
|
7.0%
|
|
Giant Tiger, Tigre Geant, Scott's Discount, Chez Tante Marie
|
|
25.00
|
3.5%
|
|
The Home Depot
|
|
25.00
|
3.0%
|
|
The Home Depot
|
|
100.00
|
3.0%
|
|
Home Hardware
|
|
25.00
|
3.5%
|
|
Home Hardware
|
|
100.00
|
3.5%
|
|
HBC - The Bay, Zellers, Home Outfitters
|
|
25.00
|
3.5%
|
|
HBC - The Bay, Zellers, Home Outfitters
|
|
100.00
|
3.5%
|
|
The Keg
|
|
25.00
|
8.0%
|
|
The Keg
|
|
50.00
|
8.0%
|
|
The Keg
|
|
100.00
|
8.0%
|
|
Kernels Popcorn - get a two for one coupon with each gift card
|
|
10.00
|
7.0%
|
|
La Senza, La Senza Girl, Silk and Satin
|
|
25.00
|
7.0%
|
|
Laura Secord
|
|
25.00
|
10.0%
|
|
Loblaws, No Frills, Zehrs, Fortinos, Valu-mart, Extra Foods, Independent, Atlantic / Real Canadian Superstore, Maxi, Provigo, Real Canadian Wholesale, National Grocers, SaveEasy, SuperValu
|
|
50.00
|
3.5%
|
|
Loblaws, No Frills, Zehrs, Fortinos, Valu-mart, Extra Foods, Independent, Atlantic / Real Canadian Superstore, Maxi, Provigo, Real Canadian Wholesale, National Grocers, SaveEasy, SuperValu
|
|
100.00
|
3.5%
|
|
Loblaws, No Frills, Zehrs, Fortinos, Valu-mart, Extra Foods, Independent, Atlantic / Real Canadian Superstore, Maxi, Provigo, Real Canadian Wholesale, National Grocers, SaveEasy, SuperValu
|
|
250.00
|
3.5%
|
|
Longos
|
|
50.00
|
3.5%
|
|
Lowe's Canada
|
|
100.00
|
2.0%
|
|
Mark's Work Warehouse, L'Equipeur
|
|
25.00
|
7.0%
|
|
Metro, Food Basics
|
|
50.00
|
3.5%
|
|
Metro, Food Basics
|
|
100.00
|
3.5%
|
|
M & M Meat Shops
|
|
25.00
|
4.0%
|
|
Moores
|
|
25.00
|
5.0%
|
|
Moxies Classic Grill
|
|
25.00
|
10.0%
|
|
NHL Online Merchandise - Not for Game Tickets
|
|
50.00
|
8.0%
|
|
Payless ShoeSource
|
|
25.00
|
10.0%
|
|
Petro-Canada
|
|
25.00
|
3.0%
|
|
Petro-Canada
|
|
50.00
|
3.0%
|
|
Petro-Canada
|
|
100.00
|
3.0%
|
|
Pier 1 Imports
|
|
25.00
|
5.0%
|
|
Pioneer Petroleums
|
|
50.00
|
1.5%
|
|
Pizza Pizza, Pizza 73
|
|
25.00
|
10.0%
|
|
Rainbow Cinema & Magic Lantern Certificate
|
|
5.00
|
7.0%
|
|
Red Lobster, Olive Garden
|
|
25.00
|
7.0%
|
|
Rona, Reno-Depot, Totem Building Supplies, Botanix, Chester DAWE
|
|
25.00
|
5.0%
|
|
Rona, Reno-Depot, Totem Building Supplies, Botanix, Chester DAWE
|
|
100.00
|
5.0%
|
|
Roots, Roots Kids, Baby Roots, Roots Home
|
|
25.00
|
15.0%
|
|
Safeway, Vons, Carrs, Genuardis, Pavilions, Dominicks, Pak n Save
|
|
50.00
|
4.0%
|
|
Sears, Sears Home, Sears Travel
|
|
25.00
|
3.5%
|
|
Sears, Sears Home, Sears Travel
|
|
100.00
|
3.5%
|
|
Shell Canada
|
|
50.00
|
2.0%
|
|
Sheridan Nurseries
|
|
25.00
|
4.0%
|
|
The Shoe Company, Town Shoes
|
|
25.00
|
7.0%
|
|
Shoppers Drug Mart / Pharmaprix
|
|
25.00
|
3.0%
|
|
Shoppers Drug Mart / Pharmaprix
|
|
100.00
|
3.0%
|
|
Jack Astor's, Alice Fazooli's, Far Niente, Reds, Canyon Creek, The Loose Moose
|
|
25.00
|
10.0%
|
|
Sobeys, IGA, Price Chopper, Foodland, FreshCo, Lawtons Drugs, Thrifty Foods, Rachelle-Bery
|
|
25.00
|
4.0%
|
|
Sobeys, IGA, Price Chopper, Foodland, FreshCo, Lawtons Drugs, Thrifty Foods, Rachelle-Bery
|
|
50.00
|
4.0%
|
|
Sobeys, IGA, Price Chopper, Foodland, FreshCo, Lawtons Drugs, Thrifty Foods, Rachelle-Bery
|
|
100.00
|
4.0%
|
|
Sport Chek, Coast Mountain Sports, Nevada Bobs in Sport Check
|
|
25.00
|
4.0%
|
|
Staples Business Depot
|
|
25.00
|
3.0%
|
|
Staples Business Depot
|
|
100.00
|
3.0%
|
|
Starbucks
|
|
25.00
|
5.0%
|
|
Subway
|
|
25.00
|
3.0%
|
|
Tim Hortons
|
|
25.00
|
4.0%
|
|
Tim Hortons
|
|
50.00
|
4.0%
|
|
Toys R Us - Babies R Us
|
|
25.00
|
2.0%
|
|
Ultramar Gas
|
|
50.00
|
2.0%
|
|
Walmart
|
|
25.00
|
2.0%
|
|
Walmart
|
|
50.00
|
2.0%
|
|
Walmart
|
|
100.00
|
2.0%
|
|
Walmart
|
|
250.00
|
2.0%
|
|
WaySpa
|
|
50.00
|
15.0%
|
|
Wendy's Restaurants
|
|
10.00
|
3.0%
|
|
Wendy's Restaurants
|
|
25.00
|
3.0%
|
|
West49, Billabong, Duke's Northshore
|
|
25.00
|
6.0%
|
|
Winners, Home Sense, Marshalls
|
|
25.00
|
8.0%
|
|
Winners, Home Sense, Marshalls
|
|
100.00
|
8.0%
|
|
|
|
GRAND TOTAL
|
|
Share with your friends: |