Southlands Elementary – Grocery Card Fundraiser

Summer Grocery Card Order Form

Parent name: ______________________________________ (please print)

Phone No: _______________________________
Email: ________________________________________________
Name of Student: ____________________________ Div:___________

Please drop off my order at JKC _____________

Store # of cards Total/Store

Save On Foods (4%) (min $100) ________@ $ ______ea $ _________

Stongs (7%) (min $100) _______ @ $______ea $_________

IGA (5%) Re-loadable ** _______ @ $50 each $_________

Shoppers Drug Mart (8%) _______ @ $25 each $ ________

Choices (5%) (any amount) _______ @ _______ea $ ________

Starbucks (5%) _______ @ $10 each $ ________

Total Amount: $ ________

Cheques enclosed __________ Payable to “Southlands PAC”

Visa/Mastercard # ________________________exp date: ___________

(If you use your credit card the school gets charged 2.5% on your purchase)

These gift cards must be paid for by cheque only

Chevron (2%) _________ @ $25 each $ _______

Cheque enclosed __________ Payable to “Southlands PAC”

Southlands Gift Card Fundraiser Program – Summer Order

This is your last chance to order Grocery Cards for the year!
Stock up on your favorite Grocery Cards and have them ready for summer
BBQ’s, birthday parties or any other occasion!

This is one of the easiest ways to donate to Southlands Elementary with out
it costing you anything.

The school receives a donation each time you purchase a Gift Card.

How the program works:

Fill in the attached form and either return it to your child’s teacher or the
PAC box in the school office, by Monday May 30th, 2011.

At the end of the following week the cards will be ready for pick up in the
Principal’s office. They will be available in the morning from 8:00-8:50 am
and after school from 3:00-3:30 pm. If your child goes to JKC simply fill in
the section on the order form and it will be delivered there.

If you have any questions or need clarification on the program, contact Sofia
Sandover at ssandover@metrofloors.com or Michelle Kokan at
mkokan@telus.net.

*Please note: For people who have a standing monthly order, this order
will be in addition to your usual order.

** IGA – Gift Cards are now re-loadable. Re-load at any IGA in BC and
use any means of payment including your favorite credit card to collect
points or miles. You can re-load between $10 and $500 each time. Our
school automatically receives a 4% donation for every dollar re-loaded.