Please help us give back to those in need of our services by purchasing gift certificates from our Scrip program!

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1 Please help us give back to those in need of our services by purchasing gift certificates from our Scrip program! You can buy gift certificates from our Scrip program and the businesses will donate a certain percentage from your purchase to Arc Northland. Money earned from this program helps provide services to our local community for people with disabilities who are in need of them. We would greatly appreciate your support for our ongoing fundraiser. Please call anytime you are in need of gift certificates. These can be great gifts, or used for personal use. Attached is an order form of available certificates we are able to order and the percentage of the donation that comes back to Arc Northland. For example, if you purchase a certificate for $25 for a business on the list you will receive a certificate for that amount to the business, and then the next column indicates the percentage amount given back to Arc Northland Scrip program. The percentage amount that is given back to Arc Northland is virtually a donation from you, without you having to spend any extra money. If you are interested in purchasing certificates, fill out the order form to request your certificates. There is a limited amount of the most popular requests on hand. Others that are not available in the office can be ordered and received within one week. Rush delivery is also available. Arc Northland is a membership-based organization serving children and adults with disabilities and their families. Arc Northland s mission is to create equal opportunity for quality living and to enhance dignity and respect for people with disabilities and their families. For over 50 years, we have been helping people with disabilities and their families overcome challenges and thrive in community life. If you have any questions, please contact Crystal at Thank you very much for your support! Crystal Taylor Program Coordinator

2 ARC NORTHLAND SCRIP ORDER FORM Updated 01/18/07 Please complete order form and return with payment (checks payable to Arc Northland Scrip): Arc Northland Scrip Program 424 W. Superior St. #201 For Office Use Only Duluth, MN Check # Date Filled: Customer Name: Address: Please mail my scrip City, State Zip I will pick up my scrip Thank you for your order. Please call with questions. APPAREL & ACCESSORIES Kohl's Dept. Store $25 4% $ Product % Qty Total Kohl's Dept. Store $100 4% $ American Eagle Outfitters 8% $ Lord &Taylor $25 4% $ Brooks Brothers 16% $ Macy's/Federated $25 9% $ Casual Male Big & Tall $25 6% $ Parisian $25 5% $ Claire's $10 9% $ Sear's $25 4% $ Dennis Uniforms $20 5% $ Younker's $25 8% $ Dress Barn $25 8% $ DINING - CASUAL/FINE Eddie Bauer $25 14% $ Product % Qty Total Express $25 13% $ 99 Restaurants $25 8% $ Finish Line $25 10% $ Applebee's $25 8% $ Ft. Locker $25 9% $ Baja Fresh $25 8% $ Gap/Banana/Old Navy $25 9% $ BD's Mongolian BBQ $20 8% $ Gymboree $25 13% $ Bennigan $25 15% $ Land's End $25 11% $ Blackwood's $10 10% $ Limited $25 9% $ Bob Evans $10 10% $ Maurice's $20 7% $ Boston Market $10 12% $ Men's Warehouse $25 8% $ Brann's $10 9% $ Motherhood $25 6% $ Buca di Beppo $25 8% $ Payless Shoes $20 13% $ California Pizza Kt. $10 4% $ Ross Dress For Less $25 8% $ Carlos O'Kelly $10 9% $ Shoe Carnival $25 5% $ Carrow's $10 8% $ Steve & Barry $25 6% $ Cheesecake Fact. $25 5% $ Talbot's $25 11% $ Chevy's Rest. $25 8% $ The Children's Place $25 12% $ Chili's $20 11% $ DEPARTMENT STORES Chuck E. Cheese $10 8% $ Product % Qty Total Claim Jumper $25 8% $ Andersons $25 4% $ Coco's $10 8% $ Beall's Dept. Store $25 9% $ Cold Stone Creamery $10 8% $ Belk Dept. Store $25 7% $ Cracker Barrel $10 9% $ Bloomingdale's $25 12% $ Damon's $25 9% $ Bloomingdale's $100 12% $ Dave & Busters $25 13% $ Bon-Ton/Elder-Beerman $25 9% $ Denny's $5 13% $ Boscov's $25 5% $ Don Pablos $25 8% $ Dillard's $25 9% $ Dining Concepts $25 9% $ JCPenney $25 7% $ Total All Columns: $

3 Garfield's $10 8% $ El Torito/Acapulco $25 8% $ Golden Corral $25 5% $ Jamba Juice $10 7% $ Grandma's $10 10% $ Johnny Rockets $20 8% $ Grandma's $25 10% $ KFC $5 9% $ Islands Rest $25 8% $ Long John Silver $5 9% $ Landry's Seafood $25 9% $ McDonald's $5 10% $ Legal Sea Foods $25 13% $ Mrs. Field's $5 10% $ Lettuce Entertain $25 12% $ P.F. Chang's $25 7% $ Logan's Roadhouse $25 8% $ Panera Bread $10 9% $ Longhorn Stkhouse $25 11% $ Papa John's $10 8% $ Lou Malnati's $10 9% $ Peet's Coffee $20 8% $ Marie Callendar's $25 18% $ Pick-Up Stix $25 12% $ Max & Erma's $20 13% $ Pizza Hut $10 9% $ Mimi's Café $25 5% $ Pretzel Time $10 10% $ O'Charley's $25 13% $ Qdoba $25 7% $ Old Chicago $11 (Lg Pizza) 50% $ Quizno's $5 8% $ Old Chicago $25 6% $ Starbuck's $10 7% $ Old Country Buffet $25 5% $ TCBY $5 10% $ Olga's Kitchen $20 8% $ Tully's Coffee $25 10% $ Outback/Carrabas $25 5% $ Wendy's Card $10 4% $ P.F. Chang's $10 7% $ DISCOUNT STORES Red Lobster/Olive Garden $25 9% $ Product % Qty Total Red Robin $10 9% $ Gordman's $25 9% $ Ruby Tuesday's $25 8% $ Kmart $25 2% $ Ruth's Chris $50 10% $ Shopko $25 4% $ Ryan's $5 7% $ TJ Maxx/Marshall's $10 7% $ Spaghetti Warehouse $20 18% $ Value City $10 9% $ Stuart Anderson's $20 14% $ ELECTRONICS & OFFICE SweetTom./Souplant. $10 8% $ Product % Qty Total Texas Roadhouse $25 8% $ Best Buy $25 2% $ TGI Friday's $20 8% $ Best Buy $100 2% $ Uno's $25 17% $ Circuit City $50 4% $ DINING - ON THE GO Office Depot $25 4% $ Product % Qty Total Office Max $25 5% $ Arby's $10 10% $ Radio Shack $25 4% $ Auntie Anne's $10 8% $ Staple's $25 8% $ Baskin Robbins $2 9% $ BOOKS & MUSIC & MOVIES Brueggers Bagels $10 7% $ Product % Qty Total Burger King $10 4% $ AMC Theaters/Loew's $25 7% $ Carl Jr.'s $5 9% $ AMC/Loew's Ticket $ % $ Chipotle Mexican Grill $10 10% $ Barnes & Noble/B Dalton $10 9% $ Coffee Bean & Tea Leaf $25 9% $ Barnes & Noble/B Dalton $25 9% $ D'Angelos/Papa Ginos $10 8% $ Blockbuster $10 7% $ Del Taco $5 4% $ Blockbuster Night Card $12 15% $ Domino's $5 5% $ Blockbuster Single Game $6 15% $ Domino's $14 Pizza/2 liter 25% $ Blockbuster Single Movie $ % $ Donatos Pizza $10 10% $ Cinemark Ticket $8 14% $ Eat'n Park $5 10% $ fye/suncoast $25 6% $ Fazoli's $25 7% $ Regal (UA) Theaters $25 8% $ Great Harvest Bread $10 8% $ Showcase/Cinema de Lux $25 9% $ Jack in the Box $15 4% $ Waldenbooks/Borders$10 10% $ Jamba Juice $10 7% $ Total All Columns: $

4 GAS & AUTO ONLINE & MAIL ORDER Advance Auto $25 7% $ Product % Qty Total BP Gas Stations $50 2% $ 1800Flowers $25 12% $ Checker/Schuck's/Kragen $25 8% $ Amazon.com $25 4% $ Family Express $25 4% $ Lillian Vernon $20 21% $ Holiday Stations $ % $ LL Bean $25 15% $ Kwik Trip $20 4% $ LL Bean $100 15% $ Marathon $25 3% $ Napster $15 download 7% $ Marathon $250 4% $ Omaha Steaks $25 9% $ Pep Boys $20 4% $ Shutterfly $25 14% $ Sheetz $100 4% $ YourGiftisYourChoice $25 10% $ Shell $ % $ YourGiftisYourChoice $50 10% $ Superamerica Car Wash $6 40% $ SALONS Superamerica $25 4% $ Product % Qty Total Tesoro $25 2% $ Darlene's $25 10% Wawa $ % $ Regis Salons $25 8% GROCERY Spa Finder $25 8% Product % Qty Total Ulta Salons $25 4% A&P Food Stores $25 4% $ SPECIALTY RETAILERS Albertson's/Jewel $100 4% $ Product % Qty Total Cub Foods $25 2% $ Bath & Body Works $10 18% $ Cub Foods $100 2% $ Bath & Body Works $25 18% $ GFS Marketplace $25 4% $ Brookstone $25 12% $ Giant Eagle $25 4% $ Build-a-Bear Wkshp $25 8% $ HEB/Central Market $25 3% $ CVS Pharmacy $25 2% $ Pathmark $25 4% $ Dream Dinners $75 8% $ Safeway $25 3% $ Family Christian Stores $10 9% $ Sentry Food's $20 3% $ Fannie May $10 25% $ ShopRite $25 4% $ GNC $25 8% $ Spartan Stores $25 2% $ Harry & David $25 12% $ Stater Bros $25 5% $ Hickory Farms $10 15% $ Stop&Shop/Giant Foods $25 4% $ Honey Baked Ham $10 12% $ Winn Dixie $25 4% $ Jo Ann Fabrics $20 6% $ HOME DÉCOR Kay Bee Toys $10 9% $ Product % Qty Total Long's Drug $25 5% $ Bed Bath & Beyond $25 7% $ Rite Aid $25 4% $ Crate & Barrel $25 8% $ Rocky Mtn Chocolate $10 13% $ Linens 'N Things $25 8% $ Sally Beauty $25 12% $ Pier 1 $25 9% $ See's Candies 1lb $ % $ Restoration Hardware $25 12% $ Sephora $20 4% $ Williams Sonoma $25 8% $ Sunglass Hut $25 12% $ Z Gallerie $50 7% $ ToysRUs/BabiesRUs $ % $ HOME IMPROVEMENT Walgreen's $20 2% $ Product % Qty Total SPORTING GOODS Ace Hardware $25 4% $ Product % Qty Total Home Depot $25 3% $ Bass Pro Shops $25 9% $ Home Depot $100 3% $ Big 5 Sporting Goods $25 8% $ Lowe's $25 4% $ Cabela's $25 11% $ Lowe's $100 4% $ Cabela's $100 11% $ Menard's $25 3% $ Dick's Sporting Goods $25 8% $ Menard's $100 3% $ Gander Mountain $25 8% $ MC Sports $25 8% $ Total All Columns: $

5 Northwest Outlet $10 10% $ Orvis $25 17% $ Sports Authority $25 8% $ TRAVEL Product % Qty Total American Airlines $50 16% $ American Airlines $100 16% $ BedandBreakfast.com $50 10% $ Best Western Int'l $25 12% $ Best Western Int'l $100 12% $ Carnival Cruise $100 8% $ Comfort Inn, Clarion $25 4% $ Quality, Sleep $25 4% $ Disney $25 7% $ Disney $100 7% $ Disney $1000 7% $ Hyatt Hotels $25 9% $ Hyatt Hotels $100 9% $ Marriott $50 12% $ Marriot $100 12% $ Ritz-Carlton $50 12% $ PHONE Product % Qty Total 675Min Phone Card $20 17% $ AT&T 100+ Pre-Paid $ % $ Crystal Flash $50 2% $ XTRA STUFF Product % Qty Total GiftCard Wrapper-16 pk $ % $ Scrip Wallet $1 15% $ Total All Columns: $ GRAND TOTAL $ ALL PAGES Please make checks payable to: Arc Northland Scrip

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