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 $2.00
Hot Tea $2.00
Hot Herbal Tea $2.00
Hot Apple Cider $2.00
Hot Chocolate $2.00
Cappuccino $2.00
Iced Coffee $2.00
Iced Tea $2.00
Lemonade $2.00
Smoothie $2.00
Extras (Free)
Snack order $1.50
Drink Punch Card $20.00
Snack Punch Card $15.00
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Total number of items ordered
Comments (i.e. number of sugars, creamers, special instructions, etc.)
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