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Credit this purchase to:

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to Fund circled below Altar Society

Family

SRE

Matthew 25 Ministry $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $

$ $ $ $ $ $ $ $ $ $ $ $ $ $ $ BLVD $20, 10% $ Body Suite $50, 10% $ Bristol Farms $100, 8% $ Brooks Shoes $25, 15% Burger King $10, 4% _____ OR Carls Jr $10, 5% _____$ Calif Pizza Kitchen, 10% - $25 _____ $100 ______ $ $ Cheesecake Factory $25, 5% $ Chevron, 1% -- $50 ________ $250 ________ $ Chilis $25, 11% $ Chipotle $10, 10% $ Chuck E Cheese $10, 7% $ Coffee Bean $25, 9% $ Container Store, 8% -- $25 ______ $100 ______ Crate and Barrel, 8% -- $25 ________ $100 _______ $ $ CVS, 6% -- $25 ________ $100 ________ $ Dave & Buster's $25, 13% $ Deep Pocket Jeans Co. $50, 10% $ Dick's Sporting Goods $25, 8% $ Disney, 2% -- $25 ________ $100 ________ $ Dominic Nail Spa $20, 10% $ Door to Door $10, 5% $ El Gringo $25, 10% $ El Sombrero $20, 10% $ Ercoles $10, 10% $ Fishbar $50, 10% $ Flemings - Outback Steakhouse $25, 8% $ Fonz's $20, 20% $ Four Daughters Kitchen $25, 10% $ Fresh Bros. Pizza $25, 10% $ GameStop $25, 3% $ Gap - Old Navy - Banana Republic $25, 10% $ Good Stuff $25, 10% $ Grow, the Produce Shop $50, 5% $ Grunions $20, 10% $ Gymboree $25, 13% $ Hermosa Beach Fish Shop $20, 25% $ The Home Depot, 4% $25 ________ $ Hush Hush Hair Salon $50, 20% $100 ________ $ Islands $25, 10% $500 ________ $ iTunes, 4% -- $15 ______ $25 _______ $ J. Crew $25, 13% $ Kettle $10, 15% $ Kohls $25, 4% $ Local Yolk $25, 10% $

Amazon.com, 2.5% -- $25 _____ $100 ______ American Girl $25, 8% AMC Theatre $25, 7% Arco, 1% -- $50 ________ $250 ________ Bacchus Wines $20, 10% Banner Stationers $20, 15% Barnes & Noble, 8% -- $10 ________ $25 ________ Barsha Wines & Spirits, $50, 10% Bath & Body $10, 13% Beach Pizza $10, 10% Beckers Bakery, 10% -- $5 ________ $25 ________ Bed Bath & Beyond $25, 6% Beehive $20, 10% Best Buy, 3% -- $25 ________ $100 ________

$ _________

Sub-Total

$

NO EXCHANGES OR RETURNS ON SCRIP SALES --- NO portion of this purchase of scrip is tax deductible --

as of June 12, 2017

AMERICAN MARTYRS SCRIP PROGRAM

Date:

Macy's, 10% -- $25 ________ $100 ________ Youth Ministry Mama D's $20, 20% M. Bread & Bagel $20, 10% General Fund - School Mangiamo $20, 10% General Fund - Preschool Manhattan Meats $25, 5% Martha's 22nd St. Grill $20, 10% McCormick & Schmick's - Charthouse, $25, 8% Michaels $25, 4% $ Falcon Window Washing, 10% Mobil, 1% -- $50 _______ $250 _______ - Tanner Falcon, 310-720-0735 Nail Garden $25, 12% New $ Noah's Bagel $10,10% Fit On Studios, $50, 10% Dr. Paul's Immediate Care, 20% Nordstrom, 6% -- $25 ______ $100 ______ $ - Paul Knittel, MD, 310-374-5600 OBs Pub & Grill $5, 10% $ Ocean Diner / Java Man $25, 10% Gary the Plumber, 5%, 310-320-9384 $ JML Carpet Cleaning, 10% Office Dep $25, 4% OR Staples $25, 4% - Ken Arruda, 310-880-0925 Olive Garden - The Yard House $25, 8% $ Manhattan Bch Dermatology, $100 10% Pages Bookstore $10, 9% - Scott Rackett, MD, 310-802-8180 Panchos $20, 10% $ Panda Express $25, 8% Pier Medical Aesthetics $100, 10%, Panera Bread $10, 9% - Douglas Mest, MD, 310-379-6074 $ Patterson Cleaners $20, 10% Simon's Automotive, 5% Peet's Coffee $20, 8% - Simon Khatchadourian, 310-318-1315 PetSmart $25, 4% P.F. Chang's / Pei Wei $25, 7% Pottery Barn - Will. Sonoma, 8% $25 ______ OTHER SERVICES (Pay vendor) $100 ______ Klutter Buster, 10% REI $25, 8% Becca Dalton 310-463-2989/Marianne Fraher 310-308-5133 Round Table Pizza $10, 10% See's $19, 18% [1-$19, 2-$38, 3-$57, 4-$76, 5-$95] Online Wellness Co, 5% (Healthy affordable products) Sephora $20, 4% Mary Hornickel 310-466-3820 So Bay Bus. Machines (Computer Repair), 20% Shell $25, 2% John Wargnier, 310-796-4959 Shellback Tavern $10, 10% Sion's $10, 10% Smart & Final $50, 3% AIRLINES & HOTEL $ American Airlines, 6% (ScripNow only) Sprouts $50, 5% $ Delta Airlines $250, 4% Spyder $25, 10% $ Starbucks, 7% -- $10 ______ $25 ______ Southwest Airlines, 4% (ScripNow only) $ Strand Cleaners $20, 10% Hilton $100/$500, 2% Subway, 6% -- $10 ______ $50 ______ Super Sport $25, 5% SPECIAL ORDERS & OTHER VENDORS Supercuts $25, 8% $ Surf Concepts $20, 10% Vendor Tabula Rasa $25, 10% $ Taco Bell $10, 5% Vendor Target, 2% -- $25 ____ $100 ____ Ten Thousand Villages $25, 5% Tin Roof - Simmzys - MB Post - Fish w/Dynamite - Arthur J - Craft Shack $50, 15% TJ Maxx - Marshalls - Home Goods, 7% -- $25 ______ $100 ______ Tomboy's $5, 10% ToysR Us - BabiesR Us $20, 3% Trilogy Spa $50, 10% Two Guns Espresso (MB only) $10, 15% Ulta Beauty Supply $25, 5% Union Pizza Company $20, 15% AM Gift Scrip, 4% (list quantity of each) Vicara Aveda Salon $50, 20% $ Vons, 4% -- $100 _____ $250 _____ $5 ______ $25 _______ Wahoos Fish Tacos $20, 5% $10 ______ $50 _______ Walgreens $25, 6% Whole Foods $100, 3% $20 ______ $100 _______ Wright's $50, 10%

___________Sub-Total

$ _________ Sub-Total

Check $$ ____________

Check # ___________________

Cash $$ ____________

Gift Cert $$ ________________

Credit $$ ____________

Seller _______________

BUYER : Verify Count and Initial Here >>>

TOTAL $$$