September/October 2021 Hot Lunch Form
Fill out one form for each student.
Price for each meal is $3.50 for the first item and $.50 for an extra serving.

September
Wed., 9/15 - Spaghetti bake, texas toast, salad, fruit, dessert
Fri, 9/17 - Corn dog, tater tots, vegetable, fruit, dessert
Wed., 9/22 - Breakfast for lunch, pancakes, bacon OR sausage, fruit
Fri., 9/24 - Chicken nuggets, mashed potatoes w/gravy, rolls, fruit, dessert
Wed., 9/29 - Sloppy joes, cheesy potatoes, vegetable, fruit, dessert
October
Fri., 10/1 - NO SCHOOL - Professional Development Day
Wed., 10/6 - Chicken rice casserole, breadstick, vegetable, fruit, dessert
Fri., 10/8 - $4.50 - Cousin's Sub Day - $4.50
Wed., 10/13 - Lazy Lasagna ( baked ravioli), texas toast, salad, fruit, dessert
Fri., 10/15 - Pizza, vegetable, fruit, dessert
Wed., 10/20 - Pulled pork sliders, potatoes au gratin, vegetable, fruit, dessert
Fri., 10/22 - Tacos, rice, corn, fruit, dessert
Wed., 10/27 - Cheeseburgers, french fries, applesauce, dessert
Fri., 10/29 - NO SCHOOL - Teachers Conferences
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First Name *
Last Name *
Email Address *
Grade Level *
Required
Order *
Select 1 answer per row!
0
1
1 + Extras
Spaghetti Bake
Corn Dog
Pancakes *
Chicken Nuggets
Sloppy Joes
Chicken Rice Casserole
Cousin's Sub **
Lazy Lasagna (Baked Ravioli)
Pizza
Pulled Pork Sliders
Tacos
Cheeseburgers
* If you ordered Pancakes (Wed., 9/22) would you like bacon or sausage? *
** If you ordered a Cousin's Sub (Fri., 10/8) we will send home (or have your child fill out) a separate small order slip with the specific order before the end of September!
Total Cost (Enter as number without $ symbol) *
Please add up your total. (Each 1 = $3.50; 1 + Extras = $4.00; Subs = $4.50)
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