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STEWART LUNCH ORDER FORM
STUDENT LUNCH CHOICES FOR WEEK OF 6/7 THROUGH 6/9
IF YOU ARE NOT ORDERING ANY MEALS FOR ANY DAY THIS WEEK, YOU DO NOT NEED TO FILL OUT THIS FORM
PLEASE REFER TO MENU ON WEBSITE FOR FULL ENTREE DESCRIPTIONS
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* Indicates required question
** PLEASE NOTE: FREE/REDUCED STUDENTS ARE REQUIRED TO BE CHARGED $.55 IF CHOOSING THE "MILK ONLY" OPTION **
Does student attend school in person (Option A)?
*
Yes
No- If you answer "NO" please do not continue filling out this form
STUDENT'S FIRST NAME
*
Your answer
STUDENT'S LAST NAME
*
Your answer
STUDENT ID (LUNCH ACCOUNT NUMBER)
*
Your answer
STUDENT'S GRADE
*
4
5
STUDENT'S TEACHER
*
Choose
BENNIS
BURNS
FAYBIK
HEASLEY
KOTESKI
MILLER
PORTER
RITENOUR
SELLARI
SMITH
VIRONE
YOUNG
MONDAY
*
CORN DOGS
CHICKEN NUGGETS
PBJ-STRAWBERRY
YOGURT
CHOCOLATE MILK ONLY - $ .55
WHITE MILK ONLY - $ .55
PACKING/NO LUNCH REQUIRED
TUESDAY
*
WALKING TACO
CHICKEN NUGGETS
PBJ-STRAWBERRY
YOGURT
CHOCOLATE MILK ONLY - $ .55
WHITE MILK ONLY - $ .55
PACKING/NO LUNCH REQUIRED
WEDNESDAY
*
PIZZA
CHICKEN NUGGETS
PBJ-STRAWBERRY
YOGURT
CHOCOLATE MILK ONLY - $ .55
WHITE MILK ONLY - $ .55
PACKING/NO LUNCH REQUIRED
PLEASE LIST ANY FOOD ALLERGIES (LEAVE BLANK IF N/A)
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