DC Dining Pass 2nd Trimester 17-18 - Constant Contact · 2017. 12. 6. · Jan – Feb (Trimester 2)...
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DC Dining Hot Lunch Pass Order Form Jan – Feb (Trimester 2) One student per form. No refunds are available. You may participate only on weeks that your student wants lunch. $5.00 per lunch $2.00 for extra servings where noted Date Restaurant Total $ Wednesday, Jan. 10 Costco Pizza Option A: Cheese pizza, cookie & water Option B: Pepperoni pizza, cookie & water Option: ____ Extra cheese ($2.00): ____ Extra pepperoni ($2.00): ____ $:_____ Wednesday, Jan. 17 (7 th grade field trip) McDonald’s Option A: Double cheeseburger, chips & water Option B: 2 Hamburgers, chips & water Option C: 6 pc Chicken McNuggets, chips, & water Order: ____ Extra 6 Chicken McNuggets ($2.00): ____ $:_____ Wednesday, Jan. 24 Wienerschnitzel Option A: Hot dog, chips & water Option B: Corn dog, chips & water Option: ____ Extra hot dog ($2.00): ____ Extra corn dog ($2.00): ____ $:_____ Wednesday, Jan. 31 (CSW Family Day) Chick-fil-A Option A: 8 piece chicken nuggets, chips & water Option B: Org. chicken sandwich (plain), chips & water Option: ____ $:_____ Wednesday, Feb. 7 Costco Pizza Option A: Cheese pizza, cookie & water Option B: Pepperoni pizza, cookie & water Option: ____ Extra cheese ($2.00): ____ Extra pepperoni ($2.00): ____ $:_____ Wednesday, Feb. 14 La Gondola Option A: Fusilli Alfredo, garlic bread & water Option B: Penne Marinara, garlic bread & water Option: ____ $:_____ Wednesday, Feb. 21 Panda Express Option A: Orange chicken/fried rice, cookie & water Option B: Orange chicken/chow mein, cookie & water Option C: Broccoli beef/fried rice, cookie & water Option D: Broccoli beef/chow mein, cookie & water Option: ____ $:_____ Wednesday, Feb. 28 Raising Cane’s Chicken Fingers, Texas toast, cookie & water Order: ____ $:_____ Student Name:____________________ Classroom:____________________ Total Attached: $_____ (Checks made payable to: St. Francis of Assisi School)
Transcript of DC Dining Pass 2nd Trimester 17-18 - Constant Contact · 2017. 12. 6. · Jan – Feb (Trimester 2)...
DC Dining Hot Lunch Pass Order Form Jan – Feb (Trimester 2)
One student per form. No refunds are available. You may participate only on weeks that your student wants lunch.
$5.00 per lunch $2.00 for extra servings where noted
Date
Restaurant
Total $
Wednesday, Jan. 10 Costco Pizza
Option A: Cheese pizza, cookie & water Option B: Pepperoni pizza, cookie & water
Option: ____ Extra cheese ($2.00): ____
Extra pepperoni ($2.00): ____
$:_____
Wednesday, Jan. 17 (7th grade field trip) McDonald’s Option A: Double cheeseburger, chips & water Option B: 2 Hamburgers, chips & water Option C: 6 pc Chicken McNuggets, chips, & water
Order: ____ Extra 6 Chicken McNuggets ($2.00): ____
$:_____
Wednesday, Jan. 24 Wienerschnitzel
Option A: Hot dog, chips & water Option B: Corn dog, chips & water
Option: ____ Extra hot dog ($2.00): ____
Extra corn dog ($2.00): ____
$:_____
Wednesday, Jan. 31 (CSW Family Day) Chick-fil-A Option A: 8 piece chicken nuggets, chips & water Option B: Org. chicken sandwich (plain), chips & water
Option: ____
$:_____
Wednesday, Feb. 7 Costco Pizza
Option A: Cheese pizza, cookie & water Option B: Pepperoni pizza, cookie & water
Option: ____ Extra cheese ($2.00): ____
Extra pepperoni ($2.00): ____
$:_____
Wednesday, Feb. 14 La Gondola Option A: Fusilli Alfredo, garlic bread & water Option B: Penne Marinara, garlic bread & water
Option: ____
$:_____
Wednesday, Feb. 21 Panda Express Option A: Orange chicken/fried rice, cookie & water Option B: Orange chicken/chow mein, cookie & water Option C: Broccoli beef/fried rice, cookie & water Option D: Broccoli beef/chow mein, cookie & water
Option: ____
$:_____
Wednesday, Feb. 28 Raising Cane’s
Chicken Fingers, Texas toast, cookie & water
Order: ____
$:_____
Student Name:____________________ Classroom:____________________
Total Attached: $_____ (Checks made payable to: St. Francis of Assisi School)
