Family Order Form Created: 11/12/2009 9:31:06 AM

Jewish Congregation of Marco Island

Great for everyday shopping including all Marco Island Supermarkets, Walgreens, CVS. We gratefully acknowledge your support and we thank
you.

Name Customer #

Check # Order Date

Product % Qty Total American Express 1.25% $ Barnes & Noble 9% $

$200.00 Booksellers $100.00
"346" Brooks 16% $ Andersons Market, 4% $ Barnes & Noble 9% $
Brothers $25.00 The $100.00 Booksellers $20.00
1-800-Flowers 25% $ Andersons Market, 4% $ Barnes & Noble 9% $
$10.00 The $25.00 Booksellers $25.00
675 Minute Total 15% $ Andersons, The 4% $ Barnes & Noble 9% $
Access Phone Card $100.00 College Bookstores
$20.00 $10.00
Andersons, The 4% $
99 Restaurant $25.00 13% $ $25.00 Barnes & Noble 9% $
College Bookstores
A Pea in the Pod 6% $ Antico Posto $25.00 12% $
$100.00
$25.00
Applebee's $25.00 ** 10% $ Barnes & Noble 9% $
A&P Food Stores 4% $ College Bookstores
$100.00 Applebee's $50.00 ** 10% $ $20.00
A&P Food Stores 4% $ Barnes & Noble 9% $
Aquarium $100.00 9% $
$25.00 College Bookstores
A-Plus Convenience 2% $ Aquarium $25.00 9% $ $25.00
Store $250.00 Baskin Robbins 9% $
Arby's $10.00 8% $
A-Plus Convenience 1.5% $ $2.00
Store $50.00 Arco $100.00 2% $ Bass Pro Shops 9% $
A.J. Wright $100.00 7% $ $100.00
Arco $250.00 3% $
Bass Pro Shops 9% $
A.J. Wright $25.00 7% $ $25.00
Arco $50.00 2% $
Acapulco Mexican 9% $ Bath & Body Works ** 18% $
Restaurant Y Cantina AT&T 125 Minute 20% $ $10.00
$25.00 Prepaid Card $9.50
Bath & Body Works ** 18% $
Ace Hardware 4% $ Athleta $25.00 9% $ $25.00
$100.00
Auto Zone $25.00 5% $ bd's Mongolian 8% $
Ace Hardware $25.00 4% $ Barbecue $20.00
Avis Car Rental 8% $
Acme $100.00 4% $ Beauty Bar $25.00 8% $
$50.00

Acme $25.00 4% $ B. Dalton Booksellers 9% $ Bed Bath & Beyond 7% $

$10.00 $25.00
Advance Auto Parts 7% $ B. Dalton Booksellers 9% $ BedandBreakfast.co ** 15% $
$25.00 $100.00 m $50.00
Aeropostale $25.00 7% $ B. Dalton Booksellers 9% $ Belk Department 7% $
$20.00 Store $25.00
Albertsons $100.00 4% $
B. Dalton Booksellers 9% $ Ben Pao $25.00 12% $
Albertsons $25.00 4% $ $25.00
Bergner's $100.00 8% $
Babbage's $25.00 3% $
Amazon.com 4% $
$100.00 Bergner's $25.00 8% $
Babies-R-Us $20.00 1.5% $
Amazon.com $25.00 4% $ Bertucci’s Italian 10% $
Babin's Seafood 9% $ Restaurant ® $25.00
AMC Single Admit 16% $ House $100.00
$9.50 Best Buy $100.00 3% $
Babin's Seafood 9% $
AMC Theatres 7% $ House $25.00 Best Buy $25.00 3% $
$25.00
Bahama Breeze 9% $
American Airlines 8% $ $25.00 Best Buy $250.00 3% $
$100.00
Baja Fresh $25.00 7% $ Best Cuts $25.00 8% $
American Airlines 8% $
$250.00 Banana Republic 9% $ Best Western 12% $
$25.00 International $100.00
American Eagle 9% $
Outfitters $25.00 Barnes & Noble 9% $ Best Western 12% $
Booksellers $10.00 International $25.00
American Express 1.25% $
$100.00

Make Checks Payable To: J.C.M.I.-scrip account Total Due All Columns: $

**Limited time bonus offer. Participating retailers and products are subject to change without notice.
Family Order Form Created: 11/12/2009 9:31:06 AM

Jewish Congregation of Marco Island

Great for everyday shopping including all Marco Island Supermarkets, Walgreens, CVS. We gratefully acknowledge your support and we thank
you.

Name Customer #

Check # Order Date

Big 5 Sporting Goods 8% $ Bookstop $25.00 9% $ Cambria Suites 4% $

$25.00 $50.00
Borders $10.00 9% $
Big Bowl $25.00 12% $ Capitol ChopHouse 9% $
Borders $25.00 9% $ $100.00
Big Cedar Lodge 9% $
$100.00 Capitol ChopHouse 9% $
BoRics $25.00 8% $ $25.00
Big Cedar Lodge 9% $
$25.00 Boscov's Department 8% $ Captain Crabs Take- 9% $
Store $25.00 Away $100.00
Big Fish $100.00 9% $
Boston Market 12% $ Captain Crabs Take- 9% $
Big Fish $25.00 9% $ $10.00 Away $25.00
Boston Store $100.00 8% $ Carl's Jr. $10.00 9% $
Black Angus $25.00 12% $
Boston Store $25.00 8% $ Carlos O'Kelly's 9% $
Blockbuster $10.00 7% $ Mexican Cafe $10.00
BP Gas $100.00 2% $
Blockbuster Specialty 15% $ Carlton Hair 8% $
Card $12.00 BP Gas $250.00 3% $ International $25.00
Blockbuster Specialty 15% $ Carnival Cruises 8% $
Card $3.79 BP Gas $50.00 2% $ $100.00
Blockbuster Specialty 15% $ Brasserie Jo $25.00 12% $ Carrabba's Italian 5% $
Card $6.00 Grill $25.00
Brenner's 9% $ Carrows Restaurant 8% $
Bloomingdale's 12% $
Steakhouse $100.00 $10.00
$100.00
Brenner's 9% $ Carrs $100.00 4% $
Bloomingdale's 12% $
Steakhouse $25.00
$25.00
Brooks Brothers 16% $ Carrs $25.00 4% $
Bloomington 9% $
$25.00
Chophouse $100.00 Carson Pirie Scott 8% $
Brooks Brothers 16% $ $100.00
Bloomington 9% $
Country Club Store
Chophouse $25.00 Carson Pirie Scott 8% $
$25.00
Blu Bar Lounge 9% $ $25.00
Bruegger's Bagels 7% $
$100.00 Carson's American 12% $
$10.00
Blu Bar Lounge 9% $ Bistro $25.00
Buca Di Beppo 8% $
$25.00 Casa Gallardo 9% $
$25.00
Blue Pointe Oyster 12% $ $25.00
Budget Car Rental 8% $
Bar & Seafood Grill Cascading Card File 25% $
$50.00
$25.00 $2.96
Build-A-Bear 8% $
Boardwalk Inn 9% $ Casual Male XL 6% $
Workshop $25.00
$100.00 $25.00
Burger King $10.00 4% $
Boardwalk Inn $25.00 9% $ Catherines $25.00 ** 8% $
Cabela's $100.00 ** 12% $
Bob Evans $10.00 10% $ Cattle Company 12% $
Cabela's $25.00 ** 12% $ (Alaska & Hawaii)
Bon-Ton $100.00 8% $ $25.00
Cadillac Bar $100.00 9% $ Celebrity Cruise ** 12% $
Bon-Ton $25.00 8% $
Lines $100.00
Cadillac Bar $25.00 9% $
Bonefish Grill $25.00 5% $
Central Market 2% $
Cafe at The Pfsiter, 9% $ $100.00
Bookstar $10.00 9% $
Milwaukee $100.00
Central Market 2% $
Bookstar $100.00 9% $ Cafe at The Pfsiter, 9% $ $25.00
Milwaukee $25.00
Bookstar $20.00 9% $ Century Theatres 4% $
Cafe Ba-Ba-Reeba! 12% $ $25.00
Bookstar $25.00 9% $ $25.00
Champps Americana 8% $
California Pizza 4% $ $25.00
Bookstop $10.00 9% $ Kitchen $10.00
Champs Sports 9% $
Bookstop $100.00 9% $ Cambria Suites 4% $ $25.00
$100.00
Bookstop $20.00 9% $ Charley's Crab 9% $
$100.00

Make Checks Payable To: J.C.M.I.-scrip account Total Due All Columns: $

**Limited time bonus offer. Participating retailers and products are subject to change without notice.
Family Order Form Created: 11/12/2009 9:31:06 AM

Jewish Congregation of Marco Island

Great for everyday shopping including all Marco Island Supermarkets, Walgreens, CVS. We gratefully acknowledge your support and we thank
you.

Name Customer #

Check # Order Date

Charley's Crab 9% $ Community Canteen 12% $ Dillard's $100.00 9% $

$25.00 $25.00
Dillard's $25.00 9% $
Chart House $100.00 9% $ Container Store 9% $
$100.00 Disney $100.00 2% $
Chart House $25.00 9% $
Container Store 9% $
$25.00 Disney $1000.00 2% $
Cheesecake Factory 5% $
$25.00 Cool Cuts $25.00 8% $ Disney $25.00 2% $
Chevron $100.00 1.5% $
Country Buffet $25.00 5% $ Dominick's $100.00 4% $
Chevron $250.00 2% $
Courtyard $100.00 8% $ Dominick's $25.00 4% $
Chevron $50.00 1.5% $
Courtyard $50.00 8% $ Domino's Pizza 5% $
Chevy's Fresh Mex 8% $ $10.00
Restaurant $25.00 Courtyard $500.00 8% $
Domino's Pizza & 2- 25% $
Chili's Grill & Bar 11% $ Cousin's Subs $10.00 9% $ liter $14.00
$25.00 Don & Charlie's 12% $
Crab House, The 9% $ Steakhouse $25.00
Chipotle $10.00 10% $ $100.00
Donatos Pizza 10% $
Chop House Brewery 6% $ Crab House, The 9% $ $10.00
$25.00 $25.00
Dots $25.00 12% $
Chuck E. Cheese 8% $ Cracker Barrel 9% $
$10.00 $10.00 Downtown Aquarium 9% $
Ciao! $25.00 12% $ Crate and Barrel 8% $ $100.00
$100.00 Downtown Aquarium 9% $
CineArts $25.00 4% $ $25.00
Crate and Barrel 8% $
Cinema de Lux 9% $ $25.00 Dream Dinners 8% $
$25.00 Crew Cuts $25.00 13% $ $75.00
Cinemark $25.00 4% $ Dressbarn $25.00 8% $
Cub Foods $100.00 2% $
Cinemark Tinseltown 4% $ Dunham's Sports 8% $
$25.00 Cub Foods $25.00 2% $ $25.00
Cineplex Odeon 7% $ CVS/pharmacy 6% $ Dunkin' Donuts 4% $
$25.00 $100.00 $10.00
Circle K $25.00 2% $ CVS/pharmacy 6% $ Eat 'n Park $10.00 10% $
$25.00
Claim Jumper 8% $ Eat 'n Park $25.00 10% $
Restaurants $25.00 D'Angelo Grilled 10% $
Sandwiches $10.00 EB Games $25.00 3% $
Claire's $10.00 9% $
Damon's Grill $25.00 9% $
EBX $25.00 3% $
Clarion Hotels 4% $
$100.00 Darden Restaurants 9% $
$25.00 Eddie Bauer $25.00 10% $
Clarion Hotels $50.00 4% $
Dave & Busters ** 15% $ Edwards Theater 8% $
Coco's Restaurant & 8% $ $25.00 $25.00
Bakery $10.00 Del Taco $10.00 4% $ Eiffel Tower $25.00 12% $
Coffee Bean & Tea 9% $
Leaf $25.00 Dell Computer 4% $ El Paso Cantina 9% $
$100.00 $25.00
Cold Stone Creamery 8% $
$10.00 Dennis Uniform 5% $ El Pollo Loco $10.00 6% $
$20.00
Comfort Inn $100.00 4% $ El Torito $25.00 9% $
Denny's $10.00 7% $
Comfort Inn $50.00 4% $ El Torito Grill $25.00 9% $
Destination Maternity 6% $
Comfort Suites 4% $ $25.00 Elder-Beerman 8% $
$100.00 Di Pescara $25.00 12% $ $100.00
Comfort Suites 4% $ Elder-Beerman 8% $
$50.00 Dick's Sporting 8% $
$25.00
Goods $25.00

Make Checks Payable To: J.C.M.I.-scrip account Total Due All Columns: $

**Limited time bonus offer. Participating retailers and products are subject to change without notice.
Family Order Form Created: 11/12/2009 9:31:06 AM

Jewish Congregation of Marco Island

Great for everyday shopping including all Marco Island Supermarkets, Walgreens, CVS. We gratefully acknowledge your support and we thank
you.

Name Customer #

Check # Order Date

Electronics Boutique 3% $ Food Emporium 4% $ Giant Foods $100.00 4% $

$25.00 $100.00
Giant Foods $25.00 4% $
Everest $25.00 12% $ Food Emporium 4% $
$25.00 Gift Card Holiday 20% $
Express $25.00 10% $ Wrapper 16 pk $5.60
foodlife $25.00 12% $
Express for Men 10% $ Gift card Wrapper 16 20% $
$25.00 Foot Locker $25.00 9% $ pk $5.60
Exxon $250.00 2% $ Footaction USA 9% $ GNC $25.00 8% $
$25.00
Exxon $50.00 1.5% $ Golden Nugget 9% $
Four Points by 9% $ $100.00
Fairfield Inn $100.00 8% $ Sheraton - Chicago
only $100.00 Golden Nugget 9% $
Fairfield Inn $50.00 8% $ $25.00
Four Points by 9% $
Sheraton - Chicago Golfsmith $25.00 8% $
Fairfield Inn $500.00 8% $ only $25.00
Goodrich Quality 4% $
Fairmont Hotels 12% $ Frankie's 5th Floor 12% $ Theaters $10.00
$100.00 Pizzeria $25.00
Gordman's $25.00 7% $
Family Christian 9% $ Frankie's Scaloppine 12% $
Stores $25.00 $25.00 Gordon Food Service 4% $
Family Express 4% $ Friends 2B Made 8% $ Marketplace $100.00
$100.00 $25.00 Gordon Food Service 4% $
Family Express 4% $ Funcoland $25.00 3% $ Marketplace $25.00
$25.00 Grand Cafe, Lake 9% $
Funset Boulevard 9% $ Geneva $100.00
Family Video $10.00 12% $ $100.00
Grand Cafe, Lake 9% $
Famous Hair $25.00 8% $ Funset Boulevard 9% $ Geneva $25.00
$25.00
Fannie May Candies 25% $ Grand Concourse 9% $
$10.00 Game Crazy $10.00 16% $ $100.00
Fashion Bug $25.00 ** 8% $ Game Stop $25.00 3% $ Grand Concourse 9% $
$25.00
Fazoli's $25.00 7% $ Gander Mountain 8% $
Grand Geneva 9% $
$25.00
Fiesta Salons $25.00 8% $ Resort $100.00
Gandy Dancer 9% $
Grand Geneva 9% $
Finish Line $25.00 10% $ $100.00
Resort $25.00
Gandy Dancer 9% $
Fire Mountain $25.00 5% $ Gratzi $25.00 12% $
$25.00
First Choice 8% $ Gap $25.00 9% $ Great Clips $25.00 8% $
Haircutters $25.00
Geneva ChopHouse 9% $ Great Harvest Bread 8% $
Fish Tales $100.00 9% $ $100.00 $10.00
Fish Tales $25.00 9% $ Geneva ChopHouse 9% $ Grotto $100.00 9% $
$25.00
Fisherman's Wharf 9% $ Grotto $25.00 9% $
Genuardis $100.00 4% $
$100.00
Guitar Center $25.00 4% $
Fisherman's Wharf 9% $ Genuardis $25.00 4% $
$25.00 Gulf Oil $25.00 2% $
GetGo $100.00 4% $
Fleming's Prime 5% $
Gymboree $25.00 13% $
Steakhouse $25.00 GetGo $25.00 4% $
Flying Dutchman, 9% $ Hair by Stewarts 8% $
The $100.00 GFS Marketplace 4% $ $25.00
$100.00
Flying Dutchman, 9% $ Hair Plus $25.00 8% $
The $25.00 GFS Marketplace 4% $
$25.00 HairMasters $25.00 8% $
Food Basics $100.00 4% $
Giant Eagle $100.00 4% $
Hallmark $25.00 4% $
Food Basics $25.00 4% $
Giant Eagle $25.00 4% $
Hard Rock Cafe 10% $
$25.00

Make Checks Payable To: J.C.M.I.-scrip account Total Due All Columns: $

**Limited time bonus offer. Participating retailers and products are subject to change without notice.
Family Order Form Created: 11/12/2009 9:31:06 AM

Jewish Congregation of Marco Island

Great for everyday shopping including all Marco Island Supermarkets, Walgreens, CVS. We gratefully acknowledge your support and we thank
you.

Name Customer #

Check # Order Date

Hardee's $10.00 8% $ Home Shopping 6% $ Jewel-Osco $25.00 4% $

Network $25.00
Harlow's $100.00 9% $ Jiffy Lube $30.00 ** 10% $
HomeGoods $100.00 7% $
Harlow's $25.00 9% $ Jo-Ann Fabrics 6% $
HomeGoods $25.00 7% $ $20.00
Harry & David $25.00 10% $
Hometown Buffet 5% $ Joe's Seafood, Prime 12% $
HeadStart Hair Care 8% $ $25.00 Steak & Stone Crab
$25.00 $25.00
Honey Baked Ham 12% $
Hearty Platter Cafe & 4% $ $10.00 Kay Jewelers $50.00 6% $
Restaraunt $100.00 Hotel Phillips $100.00 9% $ Kemah Boardwalk 9% $
Hearty Platter Cafe & 4% $ $100.00
Restaraunt $20.00 Hotel Phillips $25.00 9% $
Kemah Boardwalk 9% $
HEB $100.00 2% $ HUB 51 $25.00 12% $ $25.00

HEB $25.00 2% $ Hyatt Hotels $100.00 9% $ KFC $5.00 8% $

Herberger's $100.00 8% $ Hyatt Hotels $50.00 9% $ Kids Foot Locker 9% $

$25.00
Herberger's $25.00 8% $ Hyatt Place $100.00 9% $ Kil@Wat $100.00 9% $
Hilton Galveston 9% $ Hyatt Place $50.00 9% $ Kil@Wat $25.00 9% $
Island Resort
$100.00 Hyatt Summerfield 9% $ KMart $25.00 4% $
Suites $100.00
Hilton Galveston 9% $
Island Resort $25.00 Hyatt Summerfield 9% $ KMart $50.00 4% $
Suites $50.00
Hilton Madison 9% $ Kohl's Department 4% $
Monona Terrace Icing $10.00 9% $ Store $100.00
$100.00
Inn at the Ballpark 9% $ Kohl's Department 4% $
Hilton Madison 9% $ $100.00 Store $25.00
Monona Terrace
Inn at the Ballpark 9% $ Kwik Star $100.00 4% $
$25.00
$25.00
Hilton Milwaukee City 9% $ Kwik Star $20.00 4% $
Center $100.00 InterContinental 9% $
Milwaukee $100.00 Kwik Trip $100.00 4% $
Hilton Milwaukee City 9% $
Center $25.00 InterContinental 9% $ Kwik Trip $20.00 4% $
Milwaukee $25.00
Hilton 9% $
Minneapolis/Bloomin Islamorada Fish 9% $ L. Woods Tap & Pine 12% $
gton $100.00 Company $100.00 Lodge $25.00

Hilton 9% $ Islamorada Fish 9% $ L.L. Bean $100.00 15% $

Minneapolis/Bloomin Company $25.00
L.L. Bean $25.00 15% $
gton $25.00 Islands Restaurant 8% $
Holiday Hair $25.00 8% $ $25.00 L2O $25.00 12% $
iTunes® $15.00 4% $
Holiday Inn on the 9% $ La Dolce Vita $25.00 12% $
Beach-Galveston, TX J. Crew $25.00 13% $
$100.00 La Griglia $100.00 9% $
Holiday Inn on the 9% $ J. Jill $25.00 ** 11% $
La Griglia $25.00 9% $
Beach-Galveston, TX
$25.00 Jack in the Box 4% $
Lady Foot Locker 9% $
$10.00
Holiday Station 2% $ $25.00
Stores $25.00 Jamba Juice $10.00 7% $
Landry's Seafood 9% $
Hollywood Video 16% $ JCPenney $100.00 ** 6% $ House $100.00
$10.00 Landry's Seafood 9% $
JCPenney $25.00 ** 6% $ House $25.00
Home Depot $100.00 4% $
Jean Louis David 8% $ Lands' End $100.00 17% $
Home Depot $25.00 4% $ $25.00
Lands' End $25.00 17% $
Home Depot $500.00 4% $ Jewel-Osco $100.00 4% $
Lane Bryant $25.00 ** 8% $

Make Checks Payable To: J.C.M.I.-scrip account Total Due All Columns: $

**Limited time bonus offer. Participating retailers and products are subject to change without notice.
Family Order Form Created: 11/12/2009 9:31:06 AM

Jewish Congregation of Marco Island

Great for everyday shopping including all Marco Island Supermarkets, Walgreens, CVS. We gratefully acknowledge your support and we thank
you.

Name Customer #

Check # Order Date

Legal Sea Foods 13% $ Marcus Theatres 9% $ Mimis Cafe $25.00 8% $

$25.00 $100.00
Mitchell's Hair Styling 8% $
Lettuce Entertain You 12% $ Marcus Theatres 9% $ (NC only) $25.00
$25.00 $25.00
Mity Nice Grill $25.00 12% $
Limited, The $25.00 9% $ Marie Callender's 18% $
$25.00 Mobil $250.00 2% $
Little Caesar's Pizza 8% $
$20.00 Marriott Hotels 8% $
$100.00 Mobil $50.00 1.5% $
Loews Cineplex 7% $
Entertainment $25.00 Marriott Hotels 8% $ Mon Ami Gabi $25.00 12% $
$50.00
Logan's Roadhouse ** 10% $ Motherhood 6% $
$25.00 Marriott Hotels 8% $
Maternity $25.00
$500.00
Long John Silver's 8% $ Mr. Goodcents Subs 7% $
$5.00 Marshalls $100.00 7% $
and Pastas $10.00
Longhorn 9% $ Marshalls $25.00 7% $ Muer Seafood 9% $
Steakhouse $25.00 $100.00
Martin's Food Market 4% $
Lord & Taylor $25.00 8% $ (Not IN) $100.00 Muer Seafood $25.00 9% $

Lou Malnati's $10.00 8% $ Martin's Food Market 4% $ Multiplex Cinemas 9% $

(Not IN) $25.00 $25.00
Lowe's Home 4% $
Improvement Mason Street Grill 9% $ Nacional 27 $25.00 12% $
$100.00 $100.00
National 9% $
Lowe's Home 4% $ Mason Street Grill 9% $
Amusements $25.00
Improvement $25.00
$1000.00 Nike $25.00 12% $
MasterCuts $25.00 8% $
Lowe's Home 4% $ Noodle's & Company 8% $
Maui Jim $25.00 15% $
Improvement $25.00 $10.00
Lowe's Home 4% $ Maurices $20.00 7% $ O'Charley's $25.00 13% $
Improvement
$500.00 MC Sports $25.00 8% $ Office Depot $100.00 4% $
Macaroni Grill $25.00 11% $ Meijer (not AK, HI, IN, 3% $ Office Depot $25.00 4% $
MI, OH) $100.00
Macy's $100.00 10% $ Office Max $100.00 5% $
Meijer (not AK, HI, IN, 3% $
Macy's $25.00 10% $ MI, OH) $25.00 Office Max $25.00 5% $
Men's Wearhouse 8% $
Maggiano's Little Italy 11% $ Old Chicago $25.00 6% $
$25.00
$25.00
Menards Home 3% $ Old Country Buffet 5% $
Magic Johnson 7% $
Centers $100.00 $25.00
Theatre $25.00
Menards Home 3% $ Old Navy $25.00 9% $
Magic Pan Crepe 12% $
Centers $25.00
Stand $25.00
Mia & Maxx Hair 8% $ Olga's Kitchen 8% $
Mainstay Suites 4% $ $20.00
Studio $25.00
$100.00
Michaels $25.00 4% $ Olive Garden $25.00 9% $
Mainstay Suites 4% $
$50.00 Miller Time Pub 9% $ Omaha Steaks 11% $
(Milwaukee, WI) $25.00
Mainstreet 12% $
Restaurants $25.00 $100.00 On The Border 11% $
Miller Time Pub 9% $ $25.00
Marathon Gas 3% $
$100.00 (Milwaukee, WI) Orchard Supply 4% $
$25.00 Hardware $100.00
Marathon Gas $25.00 3% $
Milwaukee 9% $ Orchard Supply 4% $
Marathon Gas 4% $ ChopHouse $100.00 Hardware $25.00
$250.00
Milwaukee 9% $ Orchard Supply 4% $
Marcus Resorts 9% $ ChopHouse $25.00 Hardware $250.00
$100.00
Mimi Maternity 6% $ Orvis $100.00 17% $
Marcus Resorts 9% $ $25.00
$25.00

Make Checks Payable To: J.C.M.I.-scrip account Total Due All Columns: $

**Limited time bonus offer. Participating retailers and products are subject to change without notice.
Family Order Form Created: 11/12/2009 9:31:06 AM

Jewish Congregation of Marco Island

Great for everyday shopping including all Marco Island Supermarkets, Walgreens, CVS. We gratefully acknowledge your support and we thank
you.

Name Customer #

Check # Order Date

Orvis $25.00 17% $ Pesce $25.00 9% $ Randalls $100.00 4% $

Osteria Via Stato 12% $ Petite Sophisticate ** 8% $ Randalls $25.00 4% $

$25.00 $25.00
Real Seafood Co. 12% $
Outback Steakhouse 5% $ PetSmart $25.00 4% $ $25.00
$25.00
Petterino's $25.00 12% $ Red Lobster $25.00 9% $
Outlooks for Hair 8% $
$25.00 Pfister Hotel $100.00 9% $ Red Piano, 9% $
Overstock.com 8% $ Oklahoma City
$25.00 Pfister Hotel $25.00 9% $ $100.00
P&C $25.00 4% $ Phillips ChopHouse 9% $ Red Piano, 9% $
$100.00 Oklahoma City
P.F. Chang's China 8% $ $25.00
Bistro $25.00 Phillips ChopHouse 9% $
$25.00 Red Robin $25.00 9% $
Palio $25.00 12% $
Pick Up Stix $25.00 12% $ Red Sushi $100.00 9% $
Panera Bread $10.00 9% $
Pier 1 Imports $25.00 9% $ Red Sushi $25.00 9% $
Panera Bread $25.00 9% $
Pinkberry $10.00 5% $ Reel Club $25.00 12% $
Panopoulos Salon 8% $
$25.00 Piperlime $25.00 9% $ Regal Entertainment 8% $
$25.00
Papa Gino's $10.00 10% $ Pizza Hut $10.00 8% $
Regal Single Admit 15% $
Papa John's $10.00 8% $ Pizzeria Due $25.00 12% $ $9.50
Regis Salons $25.00 8% $
Parisian Store 8% $ Pizzeria Uno $25.00 12% $
$100.00 Regis Signature 8% $
Pizzeria Via Stato 12% $ Salon $25.00
Parisian Store 8% $
$25.00
$25.00 REI Sporting Goods 8% $
Planet X $25.00 3% $ $25.00
Park Avenue Grill 9% $
$100.00 Platinum Hotel, Las 9% $ Renaissance Hotels 8% $
Park Avenue Grill 9% $ Vegas $100.00 & Resorts $100.00
$25.00 Platinum Hotel, Las 9% $ Renaissance Hotels 8% $
Pathmark $25.00 4% $ Vegas $25.00 & Resorts $50.00
Plow & Hearth $10.00 25% $ Renaissance Hotels 8% $
Pavilions $100.00 4% $
& Resorts $500.00
Pottery Barn $100.00 8% $
Pavilions $25.00 4% $ Residence Inn 8% $
Pottery Barn $25.00 8% $ $100.00
Payless Shoes 13% $
$20.00 Residence Inn $50.00 8% $
Pottery Barn Kids 8% $
PBteen $100.00 8% $ $100.00 Residence Inn 8% $
Pottery Barn Kids 8% $ $500.00
PBteen $25.00 8% $
$25.00 Restoration 12% $
Peapod Online 4% $ Qdoba Mexican Grill 7% $ Hardware $100.00
Grocery $100.00 $25.00 Restoration 12% $
Peapod Online 4% $ Quality Inn $100.00 4% $ Hardware $25.00
Grocery $25.00 Rich Gas $100.00 4% $
Quality Inn $50.00 4% $
Peet's Coffee & Tea 8% $
$20.00 Rich Gas $25.00 4% $
Quality Markets 4% $
Pei Wei Asian Diner 8% $ $25.00 Ristorante Brissago, 9% $
$25.00 R.J. Grunts $25.00 12% $ Lake Geneva
Peohe's $100.00 9% $ $100.00
Radio Shack $25.00 4% $ Ristorante Brissago, 9% $
Peohe's $25.00 9% $ Lake Geneva $25.00
Rainforest Cafe 9% $
Pep Boys $20.00 4% $ $100.00 Rite Aid $25.00 4% $
Rainforest Cafe 9% $
Pesce $100.00 9% $
$25.00

Make Checks Payable To: J.C.M.I.-scrip account Total Due All Columns: $

**Limited time bonus offer. Participating retailers and products are subject to change without notice.
Family Order Form Created: 11/12/2009 9:31:06 AM

Jewish Congregation of Marco Island

Great for everyday shopping including all Marco Island Supermarkets, Walgreens, CVS. We gratefully acknowledge your support and we thank
you.

Name Customer #

Check # Order Date

Ritz-Carlton Hotel 8% $ Sears Auto Service 4% $ Skirvin Hilton $25.00 9% $

Company, LLC Center $100.00
$50.00 Sleep Inn $100.00 4% $
Sears Auto Service 4% $
River Crab $100.00 9% $ Center $25.00 Sleep Inn $50.00 4% $
River Crab $25.00 9% $ Sears Auto Service 4% $
Center $250.00 Smart & Final 3% $
$100.00
Rock Bottom 6% $ See's Candies 23% $
Restaurant $25.00 $15.60 Smart & Final $25.00 3% $
Rocky Mountain 11% $ Sentry $10.00 3% $ Smart & Final $50.00 3% $
Chocolate Factory
$10.00 Sentry $50.00 3% $ SmartStyle $25.00 8% $
Ross Dress for Less 8% $
Sephora $20.00 4% $ Software Etc. $25.00 3% $
$25.00
Roy's $25.00 5% $ Shaw's Crab House 12% $ Souplantation $25.00 8% $
$25.00
Ruby Tuesday 8% $ Spa Finder $25.00 12% $
Shaw's Supermarket 4% $
$25.00
$100.00 Spaghetti Warehouse 18% $
Ruby's Diner $25.00 5% $ $20.00
Shaw's Supermarket 4% $
Ruth's Chris Steak 10% $ $25.00 Speedway $100.00 4% $
House $50.00 Sheetz Gasoline 3% $
$100.00 Speedway $25.00 4% $
Ryan's Grill, Buffet 5% $
and Bakery $25.00 Sheetz Gasoline 3% $ Speedway Food 7% $
Safeway $100.00 4% $ $25.00 Court Card $20.00
Sheldon Cleaners 9% $ Sports Authority ** 11% $
Safeway $25.00 4% $ $5.00 $100.00
Sally Beauty Supply 12% $ Shell $100.00 ** $ Sports Authority ** 11% $
$25.00 2.5% $25.00
Saltgrass 9% $ Shell $25.00 ** $ Spring Hill Suites 8% $
Steakhouse $100.00 2.5% $100.00
Saltgrass 9% $ Shell $50.00 ** $ Spring Hill Suites 8% $
Steakhouse $25.00 2.5% $50.00
Sam's Club $100.00 2% $ Shoe Carnival $25.00 5% $ Spring Hill Suites 8% $
$500.00
Sam's Club $25.00 2% $ Shopko $25.00 ** 3% $
St. Louis Bread 9% $
Sam's Club $250.00 2% $ Shopko $50.00 ** 3% $ Company $10.00
St. Louis Bread 9% $
San Luis Resort 9% $ ShopRite $100.00 4% $
Company $25.00
$100.00
ShopRite $25.00 4% $ Staples $100.00 5% $
San Luis Resort 9% $
$25.00 Showcase $25.00 9% $ Staples $25.00 5% $
Saturday's Family 8% $
Shutterfly $25.00 ** 14% $ Star Market $100.00 4% $
Hair Care $25.00
Sav-A-Center 4% $ Simms Landing 9% $ Star Market $25.00 4% $
$100.00 $100.00
Star Theatre $25.00 7% $
Sav-A-Center $25.00 4% $ Simms Landing 9% $
$25.00 Starbucks $10.00 7% $
SaveRite Grocery 4% $
Sinclair Oil $100.00 2% $
Warehouse $100.00 Starbucks $25.00 7% $
SaveRite Grocery 4% $ Sinclair Oil $25.00 2% $
Warehouse $25.00 Stater Bros. Markets 5% $
Sing Sing Dueling 6% $ $100.00
Scoozi $25.00 12% $ Pianos $25.00 Stater Bros. Markets 5% $
Sears $100.00 4% $ Sinigual $25.00 9% $ $25.00
Steak 'n Shake 8% $
Sears $25.00 4% $ Skirvin Hilton 9% $
$10.00
$100.00
Sears $250.00 4% $

Make Checks Payable To: J.C.M.I.-scrip account Total Due All Columns: $

**Limited time bonus offer. Participating retailers and products are subject to change without notice.
Family Order Form Created: 11/12/2009 9:31:06 AM

Jewish Congregation of Marco Island

Great for everyday shopping including all Marco Island Supermarkets, Walgreens, CVS. We gratefully acknowledge your support and we thank
you.

Name Customer #

Check # Order Date

Stir Lounge, Las 9% $ The Children's Place 12% $ Ultra Service Center 1.5% $
Vegas $100.00 $25.00 $50.00
Stir Lounge, Las 9% $ The Chop House 12% $ United Artist Theater 8% $
Vegas $25.00 $25.00 $25.00
Stop & Shop (NOT 4% $ The Container Store 9% $ Uno Chicago Grill 12% $
TOPS) $100.00 $100.00 $25.00
Stop & Shop (NOT 4% $ The Container Store 9% $ Vic & Anthony's 9% $
TOPS) $25.00 $25.00 Steakhouse $100.00
stripburger at Cafe 12% $ The Great Indoors 4% $ Vic & Anthony's 9% $
Ba-Ba-Reeba! $25.00 $100.00 Steakhouse $25.00
Style America $25.00 8% $ The Great Indoors 4% $ VISA $100.00 2% $
$25.00
Subway $10.00 3% $ VISA $25.00 2% $
The Great Indoors 4% $
Subway $50.00 3% $ $250.00 VISA $50.00 2% $
The Restaurant at the 9% $
Suncoast Smoothies 8% $ Platinum $100.00 Vong's Thai Kitchen 12% $
$20.00 $25.00
The Restaurant at the 9% $
Sunglass Hut $25.00 12% $ Platinum $25.00 Vons $100.00 4% $

Sunoco $250.00 2% $ Tidewater Grill 12% $ Vons $25.00 4% $

$25.00
Sunoco $50.00 1.5% $ Wal-Mart $100.00 2% $
Timber Ridge Lodge 9% $
Super Fresh $100.00 4% $ $100.00 Wal-Mart $25.00 2% $
Timber Ridge Lodge 9% $
Super Fresh $25.00 4% $ $25.00 Wal-Mart $250.00 2% $

Super G $100.00 4% $ Tobacco Outlet Plus 4% $ Waldbaum's $100.00 4% $

$100.00
Super G $25.00 4% $ Tobacco Outlet Plus 4% $ Waldbaum's $25.00 4% $
$20.00
SuperAmerica 4% $ Waldenbooks $10.00 9% $
$100.00 Tom Thumb $100.00 4% $
Waldenbooks $25.00 9% $
SuperAmerica $25.00 4% $ Tom Thumb $25.00 4% $
Walgreens $100.00 ** 7% $
Supercuts $25.00 8% $ Tony Packo's $25.00 14% $
Walgreens $25.00 ** 7% $
Sweet Tomatoes 8% $ Tower of the 9% $
$25.00 Americas $100.00 Walnut Brewery 6% $
T-Rex $100.00 9% $ $25.00
Tower of the 9% $
Americas $25.00 Wawa $100.00 1.5% $
T-Rex $25.00 9% $
Towne Place Suites 8% $ Wawa $25.00 1.5% $
T.J. Maxx $100.00 7% $ $100.00
Towne Place Suites 8% $ Well Spa At Grand 9% $
T.J. Maxx $25.00 7% $ Geneva $100.00
$50.00
Talbots $25.00 13% $ Towne Place Suites 8% $ Well Spa At Grand 9% $
$500.00 Geneva $25.00
Tanger Outlets 8% $
$25.00 Toys-R-Us $20.00 1.5% $ Well Spa At Platinum, 9% $
Las Vegas $100.00
Tesoro $25.00 2% $ Tru $25.00 12% $ Well Spa At Platinum, 9% $
Texaco $25.00 2% $ Las Vegas $25.00
Tucci Benucch 12% $
$25.00 Well Spa, The Pfister 9% $
Texas Roadhouse 8% $ $100.00
$25.00 Tully's Coffee $10.00 10% $
Well Spa, The Pfister 9% $
TGF Hair Salon 8% $ Twin City Grill $25.00 12% $ $25.00
$25.00
Ulta Salon $25.00 4% $ Wendy's $10.00 4% $
TGI Friday's $25.00 9% $
Ultra Service Center 2% $ West Elm $100.00 8% $
the bridge Cinema de 9% $
Lux $25.00 $250.00
West Elm $25.00 8% $

Make Checks Payable To: J.C.M.I.-scrip account Total Due All Columns: $

**Limited time bonus offer. Participating retailers and products are subject to change without notice.
Family Order Form Created: 11/12/2009 9:31:06 AM

Jewish Congregation of Marco Island

Great for everyday shopping including all Marco Island Supermarkets, Walgreens, CVS. We gratefully acknowledge your support and we thank
you.

Name Customer #

Check # Order Date

White Barn Candle ** 18% $

Co $10.00
White Barn Candle ** 18% $
Co $25.00
White River Fish 9% $
House $100.00
White River Fish 9% $
House $25.00
Who-Song & Larry's 9% $
$25.00
Wildfire $25.00 12% $

Williams-Sonoma 8% $
$100.00
Williams-Sonoma 8% $
$25.00
Williams-Sonoma 8% $
Home $100.00
Williams-Sonoma 8% $
Home $25.00
Willie G's $100.00 9% $

Willie G's $25.00 9% $

Winn Dixie $100.00 4% $

Winn Dixie $25.00 4% $

Wow Bao $25.00 12% $

Yak & Yeti $100.00 9% $

Yak & Yeti $25.00 9% $

Yard House 8% $
Restaurants $25.00
Younkers $100.00 8% $

Younkers $25.00 8% $

Zappos.com $25.00 8% $

Zenden (Milwaukee, 9% $
WI) $100.00
Zenden (Milwaukee, 9% $
WI) $25.00
Zia's $25.00 12% $

Product % Qty Total

$

Make Checks Payable To: J.C.M.I.-scrip account Total Due All Columns: $

**Limited time bonus offer. Participating retailers and products are subject to change without notice.