| MERCHANT | FACE VALUE | %REBATE | # of CARDS | TOTAL |
| Applebees | $10 | 8% | ||
| Arby's | $10 | 8% | ||
| Bath & Body | $10 | 14% | ||
| Becks | $25 | 2% | ||
| Bergners | $25 | 9% | ||
| Blockbuster | $10 | 7% | ||
| BP Gas | $50 | 2% | ||
| Buffalo Wildwings | $25 | 7% | ||
| Burger King | $10 | 4% | ||
| Claires | $10 | 7% | ||
| Cracker Barrel | $10 | 9% | ||
| CVS | $25 | 2% | ||
| Dairy Queen | $10 | 4% | ||
| Delaney's Restaurant | $10 | 10% | ||
| Home Depot | $25 | 4% | ||
| HyVee | $50 | 5% | ||
| IV Food | $25 | 5% | ||
| Itunes | $15 | 3% | ||
| JCPenney | $25 | 5% | ||
| Jewel | $25 | 4% | ||
| JoAnn Fabric | $20 | 6% | ||
| KFC | $5 | 9% | ||
| Kmart | $25 | 2% | ||
| Kohl's | $25 | 4% | ||
| Marshall's/TJMaxx | $25 | 4% | ||
| Menards | $25 | 3% | ||
| Mi Margarita | $25 | 15% | ||
| Old Navy/ Gap | $25 | 9% | ||
| Papa John's Pizza | $10 | 6% | ||
| Payless Shoes | $10 | 10% | ||
| Pizza Hut | $10 | 9% | ||
| Red Lobster/Olive Garden | $25 | 8% | ||
| Sears | $25 | 4% | ||
| Shell | $25 or $50 | 3% | ||
| Staples | $25 | 6% | ||
| Starbucks | $10 | 7% | ||
| Steak & Shake | $10 | 8% | ||
| Subway | $10 | 3% | ||
| Wal-Mart | $25 or $50 | 2% | ||
| Waldenbooks/Borders | $10 | 8% | ||
| Walgreen | $25 | 4% | ||
| Wendy's | $10 | 4% | ||
| Please fill in blank lines for cards you would like ordered from www.mannaexpress.net | ||||
| Name: _____________________________ Date:_____________ TOTAL: _____________ | ||||