Revised 4/08 |
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| Name: _______________________ Date: Week of _______________ | ||||
| Price | Quantity | $ Amount | ||
| MONDAY : Chick-Fil-A: | ||||
| Chicken Sandwich | $2.75 | |||
| 8-pc Nuggets | $2.75 | |||
| Grilled Chicken Wrap | $3.50 | |||
| Caesar Wrap | $3.50 | |||
| Grilled Chicken Salad | $4.50 | |||
| Southwest Salad | $4.50 | |||
| TUESDAY: Jason's Deli: | ||||
| Mac & Cheese | $2.25 | |||
| Hot Dog | $2.25 | |||
| Grilled Cheese | $2.25 | |||
| Jr. Baked Potato | $3.50 | |||
| Cup of Soup: | ||||
Broccoli & Cheese |
$2.75 | |||
| Vegetable | $2.75 | |||
| Irish Potato | $2.75 | |||
| Cup of Chili | $3.50 | |||
| WEDNESDAY: Moe's Southwestern Grill | ||||
| Mini Masterpiece cheese quesadilla w/pico de gallo & sour cream |
$2.50 | |||
| Mini Masterpiece with Chicken cheese quesadilla w/chicken w/pico de gallo & sour cream |
$3.00 | |||
Power Wagon Taco |
$2.75 | |||
| Moo w/Chicken sm. burrito w/chicken, rice, beans, cheese & pico |
$3.00 | |||
| Wednesday continued below: | ||||
| Name: _______________________ Date: Week of _______________ | ||||
| Price | Quantity | $ Amount | ||
| WEDNESDAY: Moe's Southwestern Grill cont. | ||||
| Joey Bag of Donuts lg. burrito with rice, beans, cheese, salsa, & lettuce (add chicken for $.50) |
$6.00 | |||
| Sides: | ||||
| queso | $ .75 | |||
| sour cream | $ .75 | |||
| pico de gallo | $ .50 | |||
| THURSDAY: China Dragon | ||||
| China Dragon | ||||
| Egg Roll | $1.50 | |||
| Vegetable Fried Rice | $3.50 | |||
| Chicken Fried Rice | $3.50 | |||
| Chicken & Broccoli | $4.00 | |||
| Beef & Broccoli | $4.00 | |||
| Orange Chicken | $4.00 | |||
| Lo Mein: | ||||
Vegetable |
$4.00 | |||
Beef |
$4.00 | |||
Shrimp |
$4.00 | |||
| FRIDAY: Pizza Hut | ||||
| Slice - Cheese Pizza | $1.50 | |||
| Slice Pepperoni Pizza | $1.50 | |||
TOTAL |
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To order lunch for next day or
the whole next week, print this form and send it into school with your
daughter. The completed form, with check attached, may be turned in
during Morning
Gathering or during lunch period. The form must be received at least
one day before the day of the the student's lunch. |
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