Lunch Form
PLEASE NOTE: LUNCH MENU
FOR****NOVEMBER 1 to DECEMBER 1
*****THIS LUNCH MENU INCLUDES THURSDAY, DECEMBER
1
THE REST OF DECEMBER IS ON SEPARATE ORDER FORM TO
FOLLOW*****
Child’s Name:
__________________________________________
Grade:___________
ALL ORDERS
ARE DUE **MONDAY, OCTOBER 24th
PLEASE… One order form per
child, however, you may pay with one check for all your
family
Total Amount Enclosed:
$___________
3
MONDAYS
Qty. Daily
Item
_____
Pizza
$ 1.50 x 3 = _______
_____ Juice or Water
.75 x 3 = _______
_____ Ice
Cream
.75 x 3= _______
Monday Total=__________
3
TUESDAYS
Qty. Daily
Item
_____
Meatball Sub 6”
$ 2.50 x
3 = _______
_____ Turkey Sub
6”
$
2.50 x 3 = _______
_____ Juice or Water
.75 x
3 = _______
_____ Apple/Banana
.50 x 3 = _______
Tuesday Total= __________
4
WEDNESDAYS
Qty. Daily
Item
_____ Cheese Sub 6”
$ 2.50 x 4 =
______
_____ Tuna Sub
6”
$ 2.50 x 4 =______
_____ Juice or Water
.75 x 4 =______
_____ Homemade
Cookie
.75 x 4 =______
Wednesday Total=
__________
4
THURSDAYS
Qty. Daily
Item
_____ BLT
Sub
$ 2.50 x 4= _______
_____
Chicken Breast Sub
$ 2.50 x 4 = _______
_____ Juice or Water
.75
x 4 = _______
_____
Snacks
.75 x 4 = _______
Thursday Total= ___________
1
FRIDAY
Qty. Daily Item
_____
Pizza
$ 1.50 x 1 =_______
_____ Juice or
Water
.75 x 1
=_______
_____ Ice
Cream
.75 x 1
=_______
Friday Total
=_____________
***REMEMBER-ALL ORDERS ARE DUE
**MONDAY,
OCTOBER 24th
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