Milk Order Form 2023-2024

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Dear Parents,

St. Juliana School will again offer milk beginning Monday, August 28. We will serve low-fat white and nonfat chocolate milk. Please specify if your child is restricted to white or chocolate milk only. In the operation of child meal programs by the U.S. Department of Agriculture, no child will be discriminated against because of race, sex, color, national origin, age, or handicap.

Milk will be available on a daily cash basis for $0.25 per unit for those students who only occasionally wish to purchase milk. PLEASE NOTE that you do not have to fill out this form if you wish to occasionally purchase milk or if you do not want to order milk at all.

Your child will be issued a Milk ID card with their name and grade on it that they will receive daily from their teacher. They will exchange this ID card for milk.

Should you have any questions regarding our Milk Program, please feel free to contact the school office.

Thank you, Amanda Cooke

Email *

Parent *

Last, First

Student Name (first child) *

Last, First

Grade *

Choose one: *

Student Name (second child)

Last, First

Grade

Choose one:

Student Name (third child)

Last, First

Grade

Choose one:

Student Name (fourth child)

Last, First

Grade

Choose one:

HALF YEAR - August 28, 2023, through December 21. Your FACTS account will be billed. *

$14 per child

$28 two children

$42 three children

$56 four children

YEARLY

YEARLY August 28 - May 30, - Last full day of school.
*

$34 per child

$68 two children

$102 three children

$136 four children

HALF YEAR

Please click below to confirm your 2023-2024 Milk order and authorization to bill your FACTS account. *

I acknowledge that this will serve as an authorization to bill my FACTS account.

PARENT NAME (electronic parent signature) *

First and Last name

Send me a copy of my responses.

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