HOT LUNCH FORM
GRADES PK-8
IF INTERESTED, PLEASE FILL IN THE ORDERS BELOW. YOUR ORDER FORM AND MONEY MUST BE RETURNED NO
LATER THAN, Friday, January
20, 2012. PLEASE SEND IN EXACT CHANGE, CHECK OR
MONEY ORDER. SEPARATE FORMS ARE REQUIRED FOR
EACH CHILD SINCE THE FORMS WILL BE USED AS A TICKET ON LUNCH DAY. YOU MAY
CHOOSE TO PARTICIPATE IN ONE, ALL, OR NONE AT ALL. THANK YOU FOR YOUR COOPERATION.
TUESDAY, JANUARY
24, 2012
NAME:
____________________________GRADE _____________
# OF
ITEMS AMT. # OF ITEMS AMT.
6 CHICKEN NUGGETS $2.50 __________ __________
ICE CREAM CUP (VANILLA) $1.00 __________ __________
NUGGETS WITH MAC $3.00 __________ __________ ICE CREAM CUP
(CHOC.) $1.00 __________ __________
MAC AND CHEESSE $1.00 __________ __________ CHIPS $ .50 _________ __________
JUICE $1.00 __________
__________ SODA $
.75 __________ __________
WATER $
.75 __________ __________ FRUIT COCKTAIL $1.00
__________ __________
TOTAL __________ __________
THURSDAY, JANUARY 26, 2012
NAME:
____________________________GRADE _____________
# OF ITEMS AMT. # OF ITEMS AMT.
BARBEQUE $2.50 __________ __________ ICE CREAM CUP (VANILLA)
$1.00 _________ ___________
JUICE $1.00 __________ __________ ICE
CREAM CUP (CHOC.) $1.00 _________ ___________
POTATOES $
.75 __________
__________ GREEN
BEANS $ .50 _________ ___________
WATER $ .75 __________ __________ PEARS $1.00 _________ ___________
CHIPS $ .50
__________ __________ SODA $ .75 _________
___________
TOTAL ________ __ _______
_____________________________________________________________________________________________________________________
THREE
TUESDAY,
JANUARY 31, 2012
BROTHERS
NAME: ____________________________ GRADE: _________________
# OF ITEMS
AMT. # OF ITEMS AMT.
6 CHICKEN WINGS $4.50 __________ __________ ICE CREAM CUP
(VANILLA) $1.00 __________ __________
6 CHICKEN WINGS/WEDGES $5.00 _________ __________
ICE CREAM CUP (CHOC.)
$1.00 __________ __________
JUICE $1.00 __________ __________ PEACHES $1.00 __________ __________
WATER
$ .75 _________ __________ SODA $
.75 __________ ___________
CHIPS $
.50 __________ __________
TOTAL
__________ __________
THURSDAY, FEBRUARY
2, 2012
NAME:
____________________________GRADE _____________
# OF ITEMS AMT. # OF ITEMS AMT.
SLOPPY JOES
$2.50 __________ __________ ICE CREAM CUP (VANILLA)
$1.00 _________ ___________
CHIPS $ .50 ________ __________ ICE
CREAM CUP (CHOC.) $1.00 _________ ___________
JUICE $1.00 __________ __________ APPLESAUCE $ .50 _________ ___________
WATER $
.75 __________ __________ SODA $ .75 _________ __________
TOTAL _______ _________
PLEASE
SEND IN EXACT CHANGE; NO CHANGE WILL BE GIVEN. PLEASE DO NOT CUT LUNCH FORMS.
THIS IS THE LAST FORM THAT WILL COME
HOME. STARTING JANUARY 30TH,
THE HOT LUNCH FORMS WILL BE ON THE ST. JEROME ACADEMY HOME PAGE.