Daily Lunch Order Form Template - The Academy At Charlemont printable pdf download

Daily Lunch Order Form Template - The Academy At Charlemont

2017-18 School Year

Daily Lunch Order Form

I understand that:

 I am requesting a standing order for lunch every day for the students named below

 Students cannot depend on being able to change menu selection on any given day

 I will be charged for days when the student does not come to school (illness) unless lunch

itself is cancelled (weather, field trip for class/grade)

 I will be billed monthly for lunches and desserts charged in the prior month

 Lunch will be discontinued for any account in arrears

 I can withdraw from this program at any time by notifying the Business Office

Student #1 Name ______________________________________________________

Please order the regular lunch on the menu unless indicated by my selection below:

□

Vegetarian

Dairy-free

Gluten-free

Other allergy: ___________________

Student #2 Name ______________________________________________________

Please order the regular lunch on the menu unless indicated by my selection below:

□

Vegetarian

Dairy-free

Gluten-free

Other allergy: ___________________

Parent name:

Signature

Date

PLEASE FILL OUT AND RETURN TO THE BUSINESS OFFICE

Daily Lunch Order Form Template - The Academy At Charlemont