dc dining pass sept - dec 2016 - constant...
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DC Dining Hot Lunch Pass Order Form Sept – Oct – Nov - Dec
$5.00 per meal Wednesday, September 21 Weinerschnitzel Option A: Hot dog, chips and water Option B: Corn dog, chips and water Extra Hotdog $2.00 Extra Corndog $2.00
Option: ______
Extra hotdog: ______ Extra corndog: ______
Wednesday, September 28 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, October 5 Wise Guys Option A: Alfredo fettuccini, garlic knots and water Option B: Marinara with Penne, garlic knots and water
Option: ______
Wednesday, October 12 Taco Bell Option A: Combo burrito, chips and water Option B: 2 crunchy tacos, chips and water Option C: 2 cheesy rollups, chips and water
Option: ______
Wednesday, October 19 Subway Option A: 6” Turkey sandwich, chips and water Option B: 6” Ham sandwich, chips and water Option C: 6” Veggie sandwich, chips and water
Option: ______
Wednesday, October 26 Costco Hot Dogs Hot Dog, brownies and water ______ Wednesday, November 2nd McDonalds Option A: Double cheeseburger, chips and water Option B: 2 Hamburgers, chips and water Option C: 6 pc Chicken McNuggets, chips & water Extra 6 chicken McNuggets $2.50
Option: ______
Extra nuggets: ______
FamilyName_________________________________
DC Dining Hot Lunch Pass Order Form Sept – Oct – Nov - Dec
Wednesday, November 9 Chik Fil A Option A: 8 piece chicken nuggets, chips and water Option B: Original chicken sandwich (plain), chips and water
Option: ______
Wednesday, November 16 Kentucky Fried Chicken Box lunch (Chicken trips, biscuit and potato wedges) & water
______
Wednesday, November 30 Costco Pizza Option A: Cheese pizza, cookie and water Option B: Pepperoni pizza, cookie and water Extra slice of cheese $2.00 Extra slice of pepperoni $2.00
Option: ______
Extra Cheese: ______ Extra pepperoni: ______
Wednesday, December 7 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, December 14 Wise Guys Option A: Alfredo fettuccini, garlic knots and water Option B: Marinara with Penne, garlic knots and water
Option: ______
One student per form. No refunds are available. $5.00 per lunch Student Name: ________________ Classroom: _____ Total Cost: $______________ (Checks made payable to: St. Francis of Assisi School)
You may participate only on weeks that your student wants lunch.
FamilyName_________________________________