January Lunch Registration 3-5th Grade

Complete this form to register for select January lunch days.

Lunch orders are due no later than December 27th at 12:00 AM

Student Information

First Name

Answer Required

Last Name

Answer Required

Grade Level

Answer Required

Parent Information

First Name

Answer Required

Last Name

Answer Required

Lunch Calendar:

1/6: Hot dog, Chips, Fruit Salad

Price: $6.50

1/7: Chicken nuggets, Yogurt, Muffin

Price: $6.50

1/8: Taco-n-bag, pineapple tidbits

Price: $6.50

1/9: Cheeseburger, green beans, oranges

Price: $6.50

1/10: 1 Slice of Pizza, garden salad

Price: $6.50

1/10: 2 Slices of pizza, garden salad

Price: $9.50

1/13: Quesadilla, refried beans, apple slices

Price: $6.50

1/14: Spaghetti, bread, grapes

Price: $6.50

1/15: Grilled chicken sandwich, green peas, diced peaches

Price: $6.50

1/16: 1 Slices of Pizza, Garden Salad

Price: $6.50

1/16: 2 Slices of Pizza, Garden Salad

Price: $9.50

1/21: Chicken eggroll, rice, broccoli

Price: $6.50

1/22: Meatball sub, chips, applesauce

Price: $6.50

1/23: Hot ham and cheese croissant, cucumber, pudding

Price: $6.50

1/24: One Slice of Pizza, Garden Salad

Price: $6.50

1/24: Two Slices of Pizza, Garden Salad

Price: $9.50

1/27: Hamburger, green beans, pears

Price: $6.50

1/28: Chicken patty, sweet corn, yogurt

Price: $6.50

1/30: Mac and cheese, applesauce, carrots

Price: $6.50

1/31: 1 slice of pizza, garden salad

Price: $6.50

1/31: 2 slices of pizza, garden salad

Price: $9.50

Please fix the highlighted areas below before submitting.

January Lunch Registration 3-5th Grade