Café 233 Elementary Sack Lunch Request

Please return the following form at least 2 weeks (10 school days) prior to your event; no exceptions.

Return to your lunch aide and to Marie Leonhart at FPC (to process the form and confirm with lunch aide).

PLEASE NOTE: We are unable to provide coolers or ice packs. Proper temperatures (40°F or below) must be maintained at all times for food safety.

Contact Name: Click here to enter name.

School: Click here to choose a school.

Grade(s) Click here to enter grade/s.

Any student w/ meal modification (special diet) on file? Yes ☐ No ☐

Today’s Date: Click here to enter a date.

Sack Lunch Date: Click here to enter a date.

Destination: Click here to enter destination.

Teacher(s): Click here to enter teacher/s.

Taking lunches on Field Trip: Yes ☐ No ☐

All School Event: Yes ☐ No ☐

If Yes, leaving school at: Click to enter time. OR	If No, eating at school at: Click to enter time.

MENU: You must choose an Entrée, Milk (Juice is optional), and Sides.

You may also order a Y entrée of a Yogurt & Muffin OR Wow Butter & String Cheese.

Select Entrée Choice: Click to choose entree.	Select Y Entrée Choice: Click to choose entree.

Select Milk Choice: Click to choose a milk.	Select Juice Choice (optional): Click to choose a juice.

Select 3 Sides: Click here to choose a fruit. Click here to choose a veggie. Click here to choose Chip or Cookie.

# Sack Lunches with Chosen Entrée & Sides: Click here to enter amount.

# Sack Lunches with Y & Chosen Sides: Click here to enter amount.

Total # of Sack Lunches: Click here to enter amount.

Comments: Click to type.

(FPC OFFICE USE)	Items on Menu	Estimate Subtract New Amt
A -
Chg Scheduled Menu MPOP	B -
Chg Cons. Order Shipping Excel	Y -
Confirm Print Email Sent	Total -
Notes for Managers

Rev. 7.30.24 S:\FPC\FPC Forms & Documents\Website Forms\Cafe 233-Elementary Sack Lunch Request.docx