Hot Lunch Order Form
Each Meal is $5.00 and includes chips, and a drink.
Email address *
FOR THE ENTIRE MONTH OF December 2017
Please Submit ONE FORM FOR EACH STUDENT.
**The deadline is Monday, November 27th for the entire month of December.**
NOW ALSO OFFERING LUNCH ON FRIDAYS!

Student First Name *
Your answer
Student Last Name *
Your answer
Grade *
Mondays - Cheeseburger
Cheeseburger
Hamburger (no cheese)
none
12/4
12/11
12/18
Tuesdays - Burrito or Quesadilla
Burrito
Quesadilla
none
12/5
12/12
12/19
Wednesdays - Pizza
Cheese
perpperoni
2 Pepperoni (+$1 with meal)
2 Cheese (+$1 with meal)
none
12/13
12/20
Thursdays - Crispy Chicken Sandwich
Chicken Sandwich
Chicken Nuggets
none
12/14
12/21
Fridays - Corndog
Corndog
Hot Dog
none
12/1
12/15
Total number of lunches ordered for month *
Your answer
Total amount of money submitted to front office *
Write student names in memo line if paying by check
Your answer
PLEASE READ BEFORE SUBMITTING
**A copy of your order will be sent to your email.
**All payments must be submitted to the school office, BEFORE THE ORDER DEADLINE
**Confirmation receipt can be collected at the school office.
**No lunches will be distributed prior to payment.
**Please contact Mr. Mendoza with any questions regarding payment: mr.mendoza@sjm-k8.com
**Please contact Ms. Faecke regarding any unfilled orders: ms.faecke@sjm-k8.com
A copy of your responses will be emailed to the address you provided.
Please complete the captcha before submitting the form.
Submit
Never submit passwords through Google Forms.
This form was created inside of Saint Justin Martyr School. Report Abuse - Terms of Service - Additional Terms