Plain Elementary Take Home Meals Order Form
If you would like your child to take home meals for the days he/she is participating in eLearning, please complete this form.

Take Home Meal bags Include the following:

4 Breakfast Entrees
4 Lunch Entrees
1 Roll
4 Fresh Apples
4 Apple sauce cups

* Additional components are available and will come together in a separate bag.
   You are NOT required to take them. See Below:
 
Celery
Baby Carrots
Garden Salad
1/2 Gallon of Milk

**By submitting this form, You are requesting 4 take home breakfasts & 4 lunches**

Full Pay Students are expected to pay: $10.00
Reduced Price Students are expected to pay: $1.60
Please have money on your child's account or pay at time of service.
* Free students receive meals at no cost. Breakfast is free for everyone
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Email *
Student's First Name: *
Student's Last Name: *
Teacher: *
Student's Color Track: *
* Additional components are available and will come together in a separate bag.
   You are NOT required to take them. See Below:
 
Celery
Baby Carrots
Garden Salad
1/2 Gallon of Milk
Would you like the Additional Components sent home with your child? *
Pick-up Information
Meals will be delivered to the student at the end of day in classroom.
**By submitting this form, You are requesting 4 take home breakfasts & 4 lunches**
Full Pay Students are expected to pay: $10.00
Reduced Price Students are expected to pay: $1.60
Please have money on your child's account or pay at time of service.
* Free students receive meals at no cost. Breakfast is free for everyone
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