School Lunch Order Form
School Name
*
School Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Student Name
*
First Name
Last Name
Order Start Date
*
-
Month
-
Day
Year
Date
Hour Minutes
AM
PM
AM/PM Option
Teacher Name
*
Name
*
First Name
Last Name
Email
*
example@example.com
Please click the box in the left corner to order an item.
Categories:
All
All
Monday
Tuesday
Wednesday
Thursday
Friday
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( X )
Monday
Beverage
8-ounce bottle of Freshly Squeezed Lemonade.
$
1.00
Quantity
1
2
3
4
5
6
7
8
9
10
Item subtotal:
$
0.00
Lunch Box
The options include Fried Chicken or a 1/4 lb Hot Dog, which comes with Mac & Cheese and Glazed Carrots.
$
6.00
Entree Option
Quantity
Fried Chicken Box
1
2
3
4
5
6
7
8
9
10
Hot Dog Box
1
2
3
4
5
6
7
8
9
10
Item subtotal:
$
0.00
Fruit Choice
Please pick one fruit.
$
Free
Quantity
1
2
3
4
5
Fruit
Green Grapes
Fresh Pineapple
Item subtotal:
$
0.00
Tuesday
Lunch Box Preference
The options include Softshell Tacos or a Beef & Cheese Burrito Box, which comes with Spanish Rice and Fiesta Corn.
$
6.00
Entree Options
Quantity
Price
Soft Tacos (2)
1
2
3
4
5
6
7
8
9
10
$
6.00
Burrito
1
2
3
4
5
6
7
8
9
10
$
6.00
Item subtotal:
$
0.00
Fruit Choice
Please pick one fruit.
$
Free
Quantity
1
2
3
4
5
Fruit
Fresh Pineapple
Orange Slices
Item subtotal:
$
0.00
Wednesday
Beverage
8-ounce bottle of Freshly Squeezed Lemonade.
$
1.00
Quantity
1
2
3
4
5
6
7
8
9
10
Item subtotal:
$
0.00
Lunch Preference
The options include Chicken Nuggets or Cheeseburger accompanied by curly fries and baked beans.
$
6.00
Entree Options
Quantity
Price
Chicken Nuggets
1
2
3
4
5
6
7
8
9
10
$
6.00
Cheeseburger
1
2
3
4
5
6
7
8
9
10
$
6.00
Item subtotal:
$
0.00
Fruit Choice
Please pick one fruit choice.
$
Free
Quantity
1
2
3
4
5
Fruit
Orange Slices
Apple Slices
Item subtotal:
$
0.00
Thursday
Beverage
8-ounce bottle of Freshly Squeezed Lemonade.
$
1.00
Quantity
1
2
3
4
5
6
7
8
9
10
Item subtotal:
$
0.00
Lunch Preference
The options include Spaghetti or Chicken Alfredo, accompanied by a breadstick and seasoned green beans.
$
6.00
Entree Options
Quantity
Price
Spaghetti
1
2
3
4
5
6
7
8
9
10
$
6.00
Chicken Alfredo
1
2
3
4
5
6
7
8
9
10
$
6.00
Item subtotal:
$
0.00
Fruit Choice
Please pick one fruit.
$
Free
Quantity
1
2
3
4
5
Fruit
Green Apple Slices
Orange Slices
Item subtotal:
$
0.00
Friday
Beverage
8-ounce bottle of Freshly Squeezed lemonade
$
1.00
Quantity
1
2
3
4
5
Item subtotal:
$
0.00
Lunch Preference
The options include Cheese Pizza or Two Pepperoni Pizza Egg Rolls accompanied by curly fries.
$
6.00
Entree Options
Quantity
Price
Cheese Pizza
1
2
3
4
5
6
7
8
9
10
$
6.00
Pepperoni Pizza Egg Roll (2)
1
2
3
4
5
6
7
8
9
10
$
6.00
Item subtotal:
$
0.00
Fruit Choice
Please pick one fruit.
$
Free
Quantity
1
2
3
4
5
Fresh Strawberries
Fresh Apple
Item subtotal:
$
0.00
Payment Methods
Credit Card
Apple Pay
After submitting the form, you will be redirected to Apple Pay to complete the payment.
Google Pay
After submitting the form, you will be redirected to Google Pay to complete the payment.
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