CANTEEN LUNCH ORDER FORM (Note: orders must be placed by 8.30 am)
If you need to place an order after 8.30am, please do so but phone the office on 8264 2027 to let them know so your order is not missed. To make an electronic payment for your order or canteen credit, please transfer (allowing 2 days for payment to arrive) BSB number 105 135 AC 509 410 540. Please note your name on the description we'll see, so we can credit the correct account.
* Required
Email address
*
Your email
Lunch date:
*
MM
/
DD
/
YYYY
Student name:
*
Your answer
Room number:
*
Choose
Pre-School
Room 4
Room 6
Room 7
Room 8
Room 9
Room 10
Room 11
Room 12
Room 14
Lunch - Hot Foods
Choose
Cheeseburger (beef patty & cheese w/sauce) - $4.00
Chicken Burger with lettuce & mayo - $4.00
Vegetarian Burger with lettuce & egg free mayo - $4.00
Hot Dog with Tomato Sauce - $3.60
1/2 serve Hot Dog with Tomato Sauce - $1.80
Hot Dog with Cheese & Tomato Sauce - $4.00
1/2 serve Hot Dog with Cheese & Tomato Sauce - $2.00
Noodle Cup (BEEF) - $2.20
Noodle Cup (CHICKEN) - $2.20
Chicken Nuggets - 1 for 80 cents
Chicken Nuggets - 5 for $4.00
Side Dishes - Lunch
Choose
Corn on the cob - $0.50
2x Corn on the cob - $1.00
Potato Gems (5 for $1.00)
Potato Gems (10 for $2.00)
Hash Brown (1 for $1.50)
Meal Deals $6.00 (All meal deals come with a choice of fruit box & a choice of custard OR Jelly
Please select your meal deal (don't forget your Fruit Box & either custard OR jelly below
Meal Deal #1 - 6x Chicken Nuggets
Meal Deal #2A - Pizza - Cheese only
Meal Deal #2B - Pizza - Ham only
Meal Deal #3A - Veggie Burger
Meal Deal #3B - Beef Burger
Meal Deal #3C - Chicken Burger
Please select your meal deal (don't forget your Fruit Box & either custard OR jelly below
Meal Deal #1 - 6x Chicken Nuggets
Meal Deal #2A - Pizza - Cheese only
Meal Deal #2B - Pizza - Ham only
Meal Deal #3A - Veggie Burger
Meal Deal #3B - Beef Burger
Meal Deal #3C - Chicken Burger
All meal deals come with a fruit box & choice of Custard (Vanilla) OR Jelly (Red or Green)
Please select your Fruit Box & either Custard OR Jelly
Fruit Box - Orange
Fruit Box - Apple
Custard (Vanilla) OR
Jelly - Lime (green)
Jelly - Strawberry (red)
Milk drink option instead of Fruit Box $1.00 extra (CHOCOLATE)
Milk drink option instead of Fruit Box $1.00 extra (STRAWBERRY)
Please select your Fruit Box & either Custard OR Jelly
Fruit Box - Orange
Fruit Box - Apple
Custard (Vanilla) OR
Jelly - Lime (green)
Jelly - Strawberry (red)
Milk drink option instead of Fruit Box $1.00 extra (CHOCOLATE)
Milk drink option instead of Fruit Box $1.00 extra (STRAWBERRY)
SANDWICHES (Mon, Wed, Fri lunch)
Please select your Sandwich option & any Extras
Cheese Sandwich - $2.00
Chicken Sandwich - $3.00
Chicken, Lettuce & Mayo Sandwich $3.50
Ham Sandwich - $2.50
Vegemite Sandwich - $2.00
Tuna Sandwich - $2.00
EXTRAS - Cheese - $0.60
EXTRAS - Cucumber - $0.40
EXTRAS - Grated Carrot - $0.40
EXTRAS - Tomato $0.50
EXTRAS - Lettuce - $0.40
EXTRAS - Tomato Sauce - $0.20
EXTRAS - Mayo (Egg free)- $0.30
Please select your Sandwich option & any Extras
Cheese Sandwich - $2.00
Chicken Sandwich - $3.00
Chicken, Lettuce & Mayo Sandwich $3.50
Ham Sandwich - $2.50
Vegemite Sandwich - $2.00
Tuna Sandwich - $2.00
EXTRAS - Cheese - $0.60
EXTRAS - Cucumber - $0.40
EXTRAS - Grated Carrot - $0.40
EXTRAS - Tomato $0.50
EXTRAS - Lettuce - $0.40
EXTRAS - Tomato Sauce - $0.20
EXTRAS - Mayo (Egg free)- $0.30
ROLLS (Mon, Wed, Fri lunch)
Please select your Roll option & any extras
Cheese Roll - $2.20
Chicken Roll - $3.30
Chicken, Lettuce & Mayo - $4.00
Ham Roll - $3.00
Vegemite Roll - $2.10
Tuna Roll - $2.20
EXTRAS - Cheese - $0.60
EXTRAS - Cucumber - $0.40
EXTRAS - Lettuce - $0.40
EXTRAS - Tomato $0.50
EXTRAS - Tomato Sauce - $0.20
EXTRAS - Mayo (Egg Free) - $0.30
Please select your Roll option & any extras
Cheese Roll - $2.20
Chicken Roll - $3.30
Chicken, Lettuce & Mayo - $4.00
Ham Roll - $3.00
Vegemite Roll - $2.10
Tuna Roll - $2.20
EXTRAS - Cheese - $0.60
EXTRAS - Cucumber - $0.40
EXTRAS - Lettuce - $0.40
EXTRAS - Tomato $0.50
EXTRAS - Tomato Sauce - $0.20
EXTRAS - Mayo (Egg Free) - $0.30
SALAD PLATE - Salad plates come with Lettuce, Tomato, Cucumber, Carrot & Cheese.
Select Your Salad Plate & Optional Dressing
Salad Plate (Vegetarian) - $3.00
Chicken Salad - $5.00
Ham Salad - $4.50
Tuna Salad - $4.50
DRESSING: French
DRESSING: Mayo
Select Your Salad Plate & Optional Dressing
Salad Plate (Vegetarian) - $3.00
Chicken Salad - $5.00
Ham Salad - $4.50
Tuna Salad - $4.50
DRESSING: French
DRESSING: Mayo
DRINKS (please select from the drop down menu)
Choose
UHT Flavoured Milk - CHOCOLATE - $3.00
UHT Flavoursed Milk - STRAWBERRY - $ 3.00
Spring Water - $1.50
Fruit Box - Orange $2.00
Fruit Box - Apple - $2.00
Slushie - $1.50
CANTEEN SPECIAL ORDER DAY - To be advised
To be advised
COMMENTS ABOUT ORDER: (ie. no margarine, no sauce, etc)
Your answer
Name of person submitting Order
*
Your answer
Please add $0.05 to each order for purchase of paper bag to deliver lunch in
*
$0.05 paper bag
Required
TOTAL COST OF ORDER $
*
Your answer
A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This form was created inside of Modbury School Preschool to Year 7.
Report Abuse
Forms