Certificate Order Form for Maranatha/Emmanuel Canadian Reformed School T.R.I.P.
Contacts - Netty Vanleeuwen (519.787.7071), Brandie Swaving (519.843.3029 - school), Margareth Hoeksema (519.787.1955), Henrietta Jonker (226.486.1316)
Name: _______________________________________________________________________
Phone: _______________________ Acct:______
Order Date: ___________________
Please check one of these options
Cheques payable to: Canadian Reformed School Society (CRSS) (Cheques must be dated for the order delivery
date (Wednesday's) or sooner. Orders are due at the school office by Wednesday's 11:00 am or 7:30 p.m. Regular Order
Tuesday evenings at your local drop off location. To be delivered in 2 weeks, on Tuesdays.
Standing Order
Fergus - Cobie Hutten/Diane Niezen, Elora - Henrietta Jonker/Yke Timmerman, School - Brandie Swaving. Monthly Order
Pick Up Location:
Elora (Yke)
Elora (Henrietta)
School office
Fergus (Diane)
Fergus (Cobie)
Please deliver my order to:
%
Book/Stationary
10.0
Chapters/Coles/Indigo *
3.0
Staples Business Depot
%
Chain Stores
in grade
$10
$25
$50
$100
signature:
TOTAL
%
$0
4.0
Canadian Tire
$0
$0
3.5
Esso Gasoline
$0
Gasoline
$10
$25
$50
$100 $250
$500
TOTAL
$0
3.0
Shell Canada
$0
TOTAL
2.0
Petro Canada
$0
Best Buy
$0
3.0
Pioneer Gift Cards
$0
4.0
Canadian Tire
$0
2.0
Ultramar (gas only)
$0
3.0
Children's Place
$0
2.0
$10
$25
$50
$100
$0
Please note the different denominations for the following stores
3.5
Giant Tiger
$0
4.0
Home Hardware
$0
%
Grocery Stores
3.5
Home Outfitters/The Bay
$0
3.5
Food Basics
3.0
Sears Canada *
$0
5.0
Made In Holland
7.0
Marks Work Wearhouse
$0
5.0
M & M Meat Shops
$0
7.0
Old Navy *
$0
5.0
$0
Sobeys/Foodland/
Freshco
0
7.0
Payless Shoes
3.0
Rona
$0
5.0
Zehrs/No Frills
$0
3.0
Shoppers Drug Mart
$0
3.0
Sport Check
$0
%
Restaurants
2.0
Walmart
$0
5.0
Boston Pizza
8.0
Winners/Homesense
$0
8.0
7.0
5.0
Kelsey’s/Montana’s/Swiss
Chalet/Harvey’s
Brodericks Clothiers
$0
7.0
Pizza Pizza
Brodericks for Women
$0
4.0
Subway
5.0
Tim Hortons
Specialty Stores
10.0
10.0
*
$5
$10
$20
$25
$50
$100
$25
$50
$100 $250
TOTAL
$0
$10
$25
$50
TOTAL
$100
Casey’s Grill/East Side
Marios
Domino's Pizza
TOTAL
%
$10
These certifcates can also be used for online ordering.
Cash $ _______________________________________________________________
Total column 1
$
$0
Cheque # ____________________________________________________________
Total column 2
$
$0
Amount $ ____________________________________________________________
Total Order
$
$0
Date: ________________________________________________________________
If a problem with a card occurs, please contact any member of the TRIP
committee
Name (if different from above) _________________________________________
Order Form Update: Tuesday, April 21, 2015