PC Perk Order Form
Email address *
Name *
Your answer
Room number 3rd hour (9:38-10:24) *
Your answer
Room number 4th hour (10:27-11:13) *
Your answer
Hot Coffee $1.50
Hot Tea $1.50
Hot Herbal Tea $1.50
Hot Apple Cider $1.50
Hot Chocolate $1.50
Cappuccino $1.50
Iced Coffee $1.50
Iced Tea $1.50
Lemonade $1.50
Extras (Free)
Snack order $1.00
Drink Punch Card $15.00
Snack Punch Card $10.00
Total number of items ordered
Your answer
Comments (i.e. number of sugars, creamers, special instructions, etc.)
Your answer
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