Easy Scrip Order Form - All Other Areas
Please remember, when giving Scrip or Gift Certificates, tax & tips are to be paid in CASH - please be generous with gratuities!

Select the Scrip Amount in the second column next to the Barter Club Member's name and then choose the Quantity from the third column. Leave all others at "0".

Limited amount (usually one per month)
Can use barter slips as well

Barter Member	Scrip Amount	Quantity
49er Family Fun Park  (Grass Valley)	0 $35	0 1 2 3 4 5 6
Auburn BookHaven (Auburn)	0 $35	0 1 2 3 4 5 6
Avantgarden (Auburn)	0 Certificate $35 Certificate $50	0 1 2 3 4 5 6
Black Oak Golf Course  (Auburn)	0 $27 $50	0 1 2 3 4 5 6
Colfax Max  (Colfax) - NEW!	0 $35	0 1 2 3 4 5 6
Dawn’s Office Supply & Hallmark (Auburn)	0 $25	0 1 2 3 4 5 6
Depoe Bay Coffee (Auburn)	0 $25	0 1 2 3 4 5 6
Edelweiss  - Downtown (Auburn)	0 $35	0 1 2 3 4 5 6
El Sombrero Taqueria (Roseville)	0 $35	0 1 2 3 4 5 6
Foster Freeze (Auburn)	0 $35	0 1 2 3 4 5 6
Fudenjuice (Nevada City)	0 $35	0 1 2 3 4 5 6
Gonzo's Deli  (Folsom) - NEW!	0 $35	0 1 2 3 4 5 6
Gray Goose Bistro & Bar (Grass Valley) - NEW!	0 $35	0 1 2 3 4 5 6
Image Provocateur Full Salon (Roseville) (Gift certificates for all services)	0 $50	0 1 2 3 4 5 6
Kid's Kloset (Auburn)	0 $35	0 1 2 3 4 5 6
Larry & Lena’s Take-U-Bake (Lake Wildwood)	0 $35	0 1 2 3 4 5 6
Lou La Bonte's  (Auburn)	0 $50	0 1 2 3 4
The Lure Grill  (Chicago Park) - NEW!	0 $35	0 1 2 3 4 5 6
Mark & Monica's Family Pizza (Carmichael)	0 $35 $50	0 1 2 3 4 5 6
Outrigger Grill & Store (Rollins Lake, Colfax) - NEW!	0 $35	0 1 2 3 4
Petals & Sweets (Auburn)	0 $35	0 1 2 3 4 5 6
Pizza Express (Auburn - 2 Locations!)	0 $35	0 1 2 3 4 5 6
Raspberry Hill Golf Course (Auburn)	0 $35	0 1 2 3 4 5 6
Royal Thai (Auburn)	0 $35	0 1 2 3 4
Scentchips of Auburn	0 $25	0 1 2 3 4
Sierra Cab  (Auburn)	0 $10 $20	0 1 2 3 4 5 6
Sierra Saw  (Auburn)	0 $50	0 1 2 3 4 5 6
Spee-Dee Oil (Auburn) (Basic oil change & inspection)	0 $36	0 1 2 3 4 5 6
Smog Inspection (Auburn)	0 $60	0 1 2 3 4 5 6
The Steel Train Station (Roseville) (Gift Certificates)	0 $25	0 1 2 3
Strings of Auburn	0 $25	0 1 2 3
Subway (Auburn & Grass Valley)	0 $30	0 1 2 3 4 5 6
Sun River Clothing Company (Auburn)	0 Certificate $25 Certificate $50	0 1 2 3 4 5 6
Tango Frozen Yogurt (Auburn) - NEW!	0 $25	0 1 2 3 4 5 6
Tasty Time Ice Cream & Frozen Yogurt (Folsom) - NEW!	0 $35	0 1 2 3 4
Total Fitness (Auburn) - NEW! $60 for 10 workouts!	0 $60	0 1 2
Tsuda's Old Town Eatery (Auburn) - NEW!	0 $35	0 1 2 3 4
Wild Chicken Coffee, Beer & Wine (Loomis)	0 $25 $50	0 1 2 3 4 5 6
Your Name: Company Name: Account Number: Phone Number: Email Address: If one or more of your Scrip orders is out of stock, do you wish to backorder? Yes No Notes or Questions:
Limited amount (usually one per month) Can use barter slips as well