STUDENT LUNCH PROGRAM ORDER FORM
I want to order lunch for
Name of Student
Classroom Teacher's Name
Circle Days Ordered:
Mon. Tues. Wed. Thurs. Fri. Full Week
You can order lunch by the day(s) or by the week. The cost of
lunch this year is $3.50 per day and $17.50 for the full week. An
extra slice of pizza on pizza day is $1.50 more per slice. White
milk is included with lunch. Please enclose EXACT AMOUNT ONLY.
Because lunches are ordered a week in advance there can be NO
AMOUNT ENCLOSED IS $___________ Please Check
_______ Extra Slice
of pizza. $1.50
Extra milk can be ordered ONLY ON A WEEKLY BASIS.
I want to order extra milk at $3.25 for the full week.
Check here for 1% white _____
Parent's Name __________________________________________________
**** THIS FORM MUST BE RETURNED TO ECLC BY Friday am ****