Newly Remote Learner Meal Order Form 12/15-12/18
All breakfast includes cereal or bagel, white milk and fruit/juice. All lunch includes fruit, vegetables and choice of milk.
* Required
Email address
*
Your email
Pick-up time
*
Tuesday 12:30 and Friday 12:30
If you can't pick up we'll see what we can do
Student First Name
*
Your answer
Student Last Name
*
Your answer
Student Grade
*
Your answer
Tuesday Breakfast
*
Yes
None
Wednesday Breakfast
*
Yes
None
Thursday Breakfast
*
Yes
None
Friday Breakfast
*
Yes
None
Tuesday Lunch
*
PBJ Sandwich
Bagel Lunch w/yogurt and Cheese stick
Ham and Cheese
Fruit and Yogurt Parfait
Hummus Platter
none
Wednesday Lunch
*
PBJ Sandwich
Ham and Cheese
Fruit and Yogurt Parfait
Bagel Lunch w/yogurt and Cheese stick
Hummus Platter
none
Thursday Lunch Choice
*
PBJ Sandwich
Bagel Lunch w/yogurt and Cheese stick
Ham and Cheese
Fruit and Yogurt Parfait
Hummus Platter
None
Friday Lunch
Hummus Platter
PBJ Sandwich
Yogurt and Cheese Stick w/WG Pretzel and Graham Crackers
Ham and Cheese
Fruit and Yogurt Parfait
none
Clear selection
Milk Choice
*
None
White
Chocolate
Tuesday
Wednesday
Thursday
Friday
None
White
Chocolate
Tuesday
Wednesday
Thursday
Friday
Student food allergies
Your answer
Guardian Name (First and Last)
*
Your answer
Phone Number
*
Your answer
A copy of your responses will be emailed to the address you provided.
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