PC Perk Order Form
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Email *
Name *
Room number 2nd hour (8:45-9:30) *
Room number 3rd hour (9:30-10:15) *
 Hot Coffee $1.50***Special
Hot Tea $1.50***Special
Hot Herbal Tea $1.50***Special
Hot Apple Cider $1.50***Special
Hot Chocolate $1.50***Special
Cappuccino $1.50***Special
Iced Coffee $1.50***Special
Iced Tea $1.50***Special
Lemonade $1.50***Special
Smoothie $2.00
Extras (Free)
Snack order $1.25***Special
Drink Punch Card $15.00 ***SPECIAL
Snack Punch Card $10.00 ***SPECIAL
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Total number of items ordered
Comments (i.e. number of sugars, creamers, special instructions, etc.)
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