School Lunch Order Form

School Name

School Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Student Name

First NameLast Name

Order Start Date

Date

Hour MinutesAM/PM Option

Teacher Name

Name

First NameLast Name

Email

example@example.com

Preferences

Please click the box in the left corner to order an item.

Monday

Beverage

8-ounce bottle of Freshly Squeezed Lemonade.

$1.00 Quantity
Item subtotal:

Monday

The options include Baked Chicken or a 1/4 lb Hot Dog, which comes with Mac & Cheese and Glazed Carrots.

$6.00

Entree Option	Quantity
Fried Chicken Box
Hot Dog Box

Item subtotal:

Fruit Choice

Please pick one fruit.

Free QuantityFruit
Item subtotal:

Tuesday

Tuesday

The options include Softshell Tacos or Crispito Box, which comes with Spanish Rice and Fiesta Corn.

$6.00

Entree Options	Quantity	Price
Soft Tacos (2)		$6.00
Burrito		$6.00

Item subtotal:

Fruit Choice

Please pick one fruit.

Free QuantityFruit
Item subtotal:

Wednesday

Beverage

8-ounce bottle of Freshly Squeezed Lemonade.

$1.00 Quantity
Item subtotal:

Wednesday (Breakfast for Lunch)

The options include Pancakes, Sausage and Cheese Grits, or Cheeseburger, accompanied by curly fries.

$6.00

Entree Options	Quantity	Price
Pancakes, Sausage, & Cheese Grits		$6.00
Cheeseburger		$6.00

Item subtotal:

Fruit Choice

Please pick one fruit choice.

Free QuantityFruit
Item subtotal:

Thursday

Beverage

8-ounce bottle of Freshly Squeezed Lemonade.

$1.00 Quantity
Item subtotal:

Thursday

The options include Poppyseed Chicken w/Rice or Chicken Alfredo, accompanied by a breadstick and seasoned green beans.

$6.00

Entree Options	Quantity	Price
Poppyseed Chicken, Rice, & Green Beans		$6.00
Chicken Alfredo		$6.00

Item subtotal:

Fruit Choice

Please pick one fruit.

Free QuantityFruit
Item subtotal:

Friday

Beverage

8-ounce bottle of Freshly Squeezed lemonade

$1.00 Quantity
Item subtotal:

Friday

The options include Pepperoni Pizza or Chicken Chunks with mixed vegetables, accompanied by seasoned fries.

$6.00 Quantity
Item subtotal:

Fruit Choice

Please pick one fruit.

Free Quantity
Item subtotal:

Total

Payment Methods

Credit Card

Apple Pay

Google Pay