SCRIP Order Form

One-Time Orders:

Orders placed by Tuesday will be available at Richmond Scrip POP-UP table in Breezeway, Drop-off (7:50am - 8:15am) on Wednesday and Friday near Rich Coffee , Mt Tabor MS (upon arrangement) or near Grant High (upon arrangement)
Payment Options:
- Check (paid at order pickup)
- Credit Card (swiped or invoiced to your email - includes a 2.7% fee)

Standing Orders

Picked up on the 1st Friday of the Month on the Richmond playground, Mt Tabor MS or near Grant High
Changes to standing orders need be received 5 days prior to pick up
Mininum is $200 and filled once per month.
Payment Options
- Check(paid at order pickup)
- Billpay: Check can be mailed mail to Courtney Knudson, 6223 SE Clatsop Street, Portland, Oregon 97206
- Credit Card (swiped or invoiced to your email - includes a 2.7% fee)

Please contact Courtney Knudson at scrip@oyanokai.org if you have any questions.

The Fine Print: Scrip is the same as cash! Please safeguard your Scrip. Please verify your order – errors will be corrected only until the next order date.

One-Time OrderMonthly Standing Order

I can pickup on Richmond Scrip Pop-up Table on Wednesday or FridayI can pickup at Mt. Tabor in the officeI can pickup near Grant High School (private home)I need the Scrip Coordinator to contact me to arrange pickup

Name*

First NameLast Name

Email*

example@example.com

Phone Number*

Please enter a valid phone number.Format: (000) 000-0000.

Comments/Notes

Support LOCAL

SHOP LOCAL

** SUPPORT LOCAL ** Dennis' 7 Dees Garden Center

15% benefit to Oya No Kai THIS IS AMAZING! 7 Dees supports ONK more than any other local company. Dennis’ 7 Dees is a local, family-owned and operated landscaping and garden center business serving Oregon and southwest Washington since 1956.

$25.00

	Quantity
$25
$50

Item subtotal:$0.00

Burgerville

10% benefit to Oya No Kai

$10.00

	Quantity	Price
$10		$10.00
$25		$25.00

Item subtotal:$0.00

Coco Donuts

20% benefit to Oya No Kai

$10.00

	Quantity	Price
$10		$10.00

Item subtotal:$0.00

New Seasons

5% benefit to Oya No Kai

$50.00

	Quantity	Price
$50		$50.00
$100		$100.00

Item subtotal:$0.00

Hapa Ramen

20% benefit to Oya No Kai

$15.00

	Quantity	Price
$15		$15.00

Item subtotal:$0.00

Hot Lips

ON REORDER - CHECK BACK AFTER JAN 1

$ Free Quantity
Item subtotal:$0.00

Columbia

Good at retail, outlets, and employee store. 12% benefit to Oya No Kai

$50.00

	Quantity	Price
$50		$50.00

Item subtotal:$0.00

McMenamins

15% benefit to Oya No Kai

$ Free

	Quantity
$10
$25
$50

Item subtotal:$0.00

Pizza Schmizza

10% benefit to Oya No Kai

$5.00

	Quantity	Price
$5		$5.00

Item subtotal:$0.00

Grocery

Fred Meyer/QFC

5% benefit to Oya No Kai

$10.00

	Quantity	Price
$10		$10.00
$50		$50.00
$100		$100.00
$200		$200.00

Item subtotal:$0.00

Safeway

4% benefit to Oya No Kai

$25.00

	Quantity	Price
$25		$25.00
$50		$50.00
$100		$100.00

Item subtotal:$0.00

New Seasons

5% benefit to Oya No Kai

$50.00

	Quantity	Price
$50		$50.00
$100		$100.00

Item subtotal:$0.00

Whole Foods

3% benefit to Oya No Kai

$50.00

	Quantity	Price
$50		$50.00
$100		$100.00

Item subtotal:$0.00

Car

Chevron

1% benefit to Oya No Kai

$50.00

	Quantity	Price
$50		$50.00

Item subtotal:$0.00

Ecowash

26% benefit to Oya No Kai

$6.00

	Quantity	Price
$6		$6.00

Item subtotal:$0.00

Retail

** SUPPORT LOCAL ** Dennis' 7 Dees Garden Center

15% benefit to Oya No Kai THIS IS AMAZING! 7 Dees supports ONK more than any other local company. Dennis’ 7 Dees is a local, family-owned and operated landscaping and garden center business serving Oregon and southwest Washington since 1956.

$25.00

	Quantity
$25
$50

Item subtotal:$0.00

Amazon

4% benefit to Oya No Kai

$10.00

	Quantity	Price
$10		$10.00
$100		$100.00

Item subtotal:$0.00

Barnes + Noble

8% benefit to Oya No Kai

$10.00

	Quantity	Price
$10		$10.00
$25		$25.00

Item subtotal:$0.00

Bridgeport Village

All stores, restaurants, theater, kiosks, except Croc store. 4% benefit to Oya No Kai

$25.00

	Quantity	Price
$25		$25.00

Item subtotal:$0.00

Columbia

Good at retail, outlets, and employee store. 12% benefit to Oya No Kai

$50.00

	Quantity	Price
$50		$50.00

Item subtotal:$0.00

Gap

14% Benefit to Oya No Kai

$25.00

	Quantity	Price
$25		$25.00

Item subtotal:$0.00

Home Depot

3% benefit to Oya No Kai

$25.00

	Quantity	Price
$25		$25.00
$100		$100.00

Item subtotal:$0.00

Lowe's

4% benefit to Oya No Kai

$50.00

	Quantity	Price
$50		$50.00

Item subtotal:$0.00

Macy's

10% benefit to Oya No Kai

$25.00

	Quantity	Price
$25		$25.00

Item subtotal:$0.00

Walgreens

$25.00

	Quantity	Price
$25		$25.00

Item subtotal:$0.00

Nike

12% benefit to Oya No Kai

$50.00

	Quantity	Price
$50		$50.00

Item subtotal:$0.00

Ross

8% benefit to Oya No Kai

$25.00

	Quantity	Price
$25		$25.00

Item subtotal:$0.00

Restaurants

Burgerville

10% benefit to Oya No Kai

$10.00

	Quantity	Price
$10		$10.00
$25		$25.00

Item subtotal:$0.00

Dominoes

12% benefit to Oya No Kai

$10.00

	Quantity	Price
$10		$10.00

Item subtotal:$0.00

Coco Donuts

20% benefit to Oya No Kai

$10.00

	Quantity	Price
$10		$10.00

Item subtotal:$0.00

Hapa Ramen

20% benefit to Oya No Kai

$15.00

	Quantity	Price
$15		$15.00

Item subtotal:$0.00

Hot Lips

ON REORDER - CHECK BACK AFTER JAN 1

$ Free Quantity
Item subtotal:$0.00

McMenamins

15% benefit to Oya No Kai

$ Free

	Quantity
$10
$25
$50

Item subtotal:$0.00

Olive Garden

8% benefit to Oya No Kai

$10.00

	Quantity	Price
$10		$10.00

Item subtotal:$0.00

Panera

9% benefit to Oya No Kai

$10.00

	Quantity	Price
$10		$10.00

Item subtotal:$0.00

Papa Murphy

8% benefit to Oya No Kai

$10.00

	Quantity	Price
$10		$10.00

Item subtotal:$0.00

The Old Spaghetti Factory

$10.00

	Quantity	Price
$10		$10.00

Item subtotal:$0.00

Pastini

8% benefit to Oya No Kai

$25.00

	Quantity	Price
$25		$25.00

Item subtotal:$0.00

Peet's Coffee

8% benefit to Oya No Kai

$20.00

	Quantity	Price
$20		$20.00

Item subtotal:$0.00

Pizza Schmizza

10% benefit to Oya No Kai

$5.00

	Quantity	Price
$5		$5.00

Item subtotal:$0.00

Starbucks

6% benefit to Oya No Kai

$10.00

	Quantity	Price
$10		$10.00
$25		$0.00

Item subtotal:$0.00

Entertainment

Apple iTunes

5% benefit to Oya No Kai

$15.00

	Quantity	Price
$15		$15.00
$25		$25.00

Item subtotal:$0.00

Cinemark

4% benefit to Oya No Kai

$9.00

	Quantity	Price
$9		$9.00
$25		$25.00

Item subtotal:$0.00

Regal Cinemas

8% benefit to Oya No Kai

$15.00

	Quantity	Price
$15		$15.00

Item subtotal:$0.00

Subtotal

$0.00

Tax

$0.00

Total

$0.00

Pay with PayPal

Choose from one of the PayPal options to make your payment.