NAME TELEPHONE PAYABLE TO

SMFSC

EMAIL ADDRESS

NOTES

Please attach cheque to form and submit in blue box in rink 3.

THE ESSENTIALS

Grocery

% $ QT $ QT $ QT $ QT $ QT Total $Retailer

3% $25 > $50 > $100 > $250 >food BASIC$,Metro (Ontario Only)

3% $10 > $25 > $50 > $100 > $250 >

Loblaws, Bloor Street Market, Extra Foods,Fortinos, No Frills, Real Canadian Superstore,Real Canadian Wholesale Club, Valu-Mart, YourIndependent Grocer, Zehrs

3% $20 > $50 > $100 >Longo's

3% $25 > $50 >M&M Food Market

2% $25 > $50 > $100 > $250 >Sobeys, Foodland, FreshCo, IGA, Price Chopper,Safeway

Gas

% $ QT $ QT $ QT $ QT $ QT Total $Retailer

2% $25 > $50 > $100 >Esso

2% $50 >Irving Oil

2% $25 > $50 > $100 > $500 >Petro-Canada

2% $25 > $50 > $100 > $500 >Shell

2% $10 > $25 > $50 > $100 >Ultramar

OTHER CATEGORIES

Restaurant & Coffee

% $ QT $ QT $ QT $ QT $ QT Total $Retailer

4% $10 > $25 >A&W

5% $25 > $50 >

Abbey’s Bakehouse,Alice Fazooli’s,Canyon CreekChop House,Duke’s Refresher,Jack Astor’s® Barand Grill,Loose Moose Tap &Grill®,reds®,Scaddabush,The Antler Room

5% $25 > $50 >Boston Pizza

5% $25 > $50 >Earl's

6% $25 > $50 >JOEY

5% $25 > $50 > $100 >

Kelsey's, D'Arcy McGee's, East Side Mario's,Fionn MacCool's, Harvey's, Milestones,Montana's, New York Fries, Paddy Flaherty's,Prime Pubs, Swiss Chalet, The Biermarkt, TheUltimate Dining Card, Tir Nan Óg

3% $25 > $50 >Kentucky Fried Chicken,Pizza Hut,Taco Bell

10% $50 > $100 >Moxie's Grill & Bar

10% $25 > $100 > $500 >Pizza Pizza

5% $25 >Red Lobster

5% $5 > $25 >Starbucks

4% $25 >St-Hubert BBQ, St-Hubert Express

3% $25 > $100 > $500 >SUBWAY®

created on 10/20/2017Streetsville Meadowvale Figure Skating Club

IMPORTANT NOTE : Retailers, rebates and card denominations subject to change without notice. Retailers, rebates and card denominations indicated on the FundScripwebsite will supersede those on this paper order form.

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created on 10/20/2017Streetsville Meadowvale Figure Skating Club

Restaurant & Coffee (Continued)

% $ QT $ QT $ QT $ QT $ QT Total $Retailer

10% $10 > $25 >Teriyaki Experience

5% $25 > $50 > $100 >The Keg Steakhouse + Bar

5% $25 > $50 >The Old Spaghetti Factory

2% $15 > $25 >Tim Hortons

3% $10 >Wendy's

Apparel

% $ QT $ QT $ QT $ QT $ QT Total $Retailer

6% $50 > $100 >Aerie

10% $25 >Aldo

6% $50 > $100 >American Eagle Outfitters®

4% $20 >Claire's

5% $25 > $50 >Gap, Baby Gap, Banana Republic, Old Navy

7% $25 >La Senza, La Senza Express

8% $25 > $50 >La Vie en Rose, Bikini Village

3.5% $25 > $50 >Le Château

7% $25 > $50 > $100 >Mark's

10% $25 >Roots, Roots Home, Roots Kids

5% $25 >Sunglass Hut

6% $50 > $100 >Suzy Shier

6% $25 > $50 >Warehouse One

Business & Office

% $ QT $ QT $ QT $ QT $ QT Total $Retailer

3% $25 > $50 > $100 > $200 > $500 >Staples/Business Depot

Children & Toys

% $ QT $ QT $ QT $ QT $ QT Total $Retailer

7% $25 >Build-A-Bear Workshop

6% $25 >Gymboree

5% $25 > $50 >Scholar's Choice

8% $25 > $50 >The Children's Place

2% $25 > $100 >Toys R Us, BabiesRus

Department Stores

% $ QT $ QT $ QT $ QT $ QT Total $Retailer

2% $25 > $50 > $100 > $250 >Amazon.ca

3% $25 > $100 >Giant Tiger

3% $10 > $25 > $50 > $100 >Hudson's Bay, Home Outfitters

2% $10 > $25 > $50 > $100 > $250 >Walmart

6% $10 > $25 > $50 >Winners, Home Sense, Marshalls

Electronics

% $ QT $ QT $ QT $ QT $ QT Total $Retailer

1.5% $25 > $50 > $100 >Best Buy

2% $50 > $100 >The Source

Entertainment

% $ QT $ QT $ QT $ QT $ QT Total $Retailer

IMPORTANT NOTE : Retailers, rebates and card denominations subject to change without notice. Retailers, rebates and card denominations indicated on the FundScripwebsite will supersede those on this paper order form.

Page 2 / 4

created on 10/20/2017Streetsville Meadowvale Figure Skating Club

Entertainment (Continued)

% $ QT $ QT $ QT $ QT $ QT Total $Retailer

5% $5 > $10 > $25 > $100 >Chapters, Coles Books, Indigo

4% $10 > $25 > $100 >Cineplex, Galaxy, Scotiabank, SilverCity

Health & Beauty

% $ QT $ QT $ QT $ QT $ QT Total $Retailer

5% $25 > $50 >Bath and Body Works Canada

10% $25 >Fruits and Passion, Nature Collection, THE FACESHOP

5% $25 >Regis Salons, Borics Hair Care, Hairmasters,Mastercuts

10% $25 >Sally Beauty

4% $25 > $50 >Sephora

3% $25 > $100 >Shoppers Drug Mart

10% $25 > $50 > $100 >WaySpa

Home & Garden

% $ QT $ QT $ QT $ QT $ QT Total $Retailer

4% $10 > $25 > $50 > $100 >Canadian Tire

3% $25 > $50 > $100 > $500 >Home Depot

3% $25 > $100 > $500 > $1000 >Home Hardware, Home Furniture

5% $25 >Pier 1

3% $25 > $50 > $100 > $500 >RONA

6% $25 >Stokes, ThinkKitchen

Specialty

% $ QT $ QT $ QT $ QT $ QT Total $Retailer

3% $25 > $50 >DAVIDsTEA

3% $25 > $50 >Groupon

3% $25 >iTunes

5% $15 > $100 >Kernels Popcorn

7% $25 >Laura Secord

4% $100 >MOLLY MAID

2% $25 > $50 >PetSmart

Sports & Leisure

% $ QT $ QT $ QT $ QT $ QT Total $Retailer

4% $25 > $50 >Bass Pro Shops

4% $25 > $50 > $100 >Cabela's

5% $25 > $50 >Foot Locker

3% $25 > $50 > $100 >Golf Town

7% $50 >LifeExperiences.ca

6% $25 > $50 >Running Room

4% $25 >Sport Chek

5% $50 > $100 >West 49

Travel

% $ QT $ QT $ QT $ QT $ QT Total $Retailer

2.5% $50 >Best Western

8% $100 > $250 >Fairmont Hotels & Resorts, WillowStream

IMPORTANT NOTE : Retailers, rebates and card denominations subject to change without notice. Retailers, rebates and card denominations indicated on the FundScripwebsite will supersede those on this paper order form.

Page 3 / 4

created on 10/20/2017Streetsville Meadowvale Figure Skating Club

TOTAL OF THIS ORDER $

IMPORTANT NOTE : Retailers, rebates and card denominations subject to change without notice. Retailers, rebates and card denominations indicated on the FundScripwebsite will supersede those on this paper order form.

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