Midland Elementary Lunch Request Form

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Please make your weekly lunch selections below. For each meal selected a charge of $3.75 will be applied to your student's lunch account. Each meal selection includes: bottled water and daily vegetable & fruit option. Ordering closes at 3pm Friday for start of new week.

Email *

Student's Grade *

Teacher's Name *

Student's Name (first and last) *

Week Selected *

Monday Selection

Tuesday Selection

Wednesday Selection

Thursday Selection

Friday Selection

2nd Helping for the entire week: *

Yes, add an additional entre and water for $2.75

No 2nd Helping

In the event your child is quarentined please contact food service to cancel your order. If the order is not canceled, my student's account will be charged. *

I agree

Required

A copy of your responses will be emailed to the address you provided.

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