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2015 eRate RFP
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Lunch Selections
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Indicates required field
Prepaid Card Account Name
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First
Last
Age
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4
5
6
7
8
9
10
11
12
Adult
Account Contact Name
*
First
Last
My child will be purchasing lunch on the following days:
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Tuesday
Wednesday
Thursday
Friday
My child will be bringing lunch
Contact Phone Number
*
Email
*
Tuesday Entree
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No Selection
Chicken Tenders
Tuesday Side Dish
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No Selection
Salad
Spring Mix Fruit
Fries
Broccoli
Tuesday Drink
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No Selection
Apple Juice
Fruit Juice
Water
Wednesday Entree
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No Selection
Mini Corndogs
Chicken Tenders
Wednesday Side Dish
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No Selection
Salad
Spring mix fruit
Fries
Broccoli
Wednesday Drink
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No Selection
Apple Juice
Fruit Juice
Water
Thursday Entree
*
No Selection
Cheeseburger
Turkey Burger
Chicken Tenders
Thursday Side Dish
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No Selection
Spring mix fruit
Salad
Fries
Broccoli
Thursday Drink
*
No Selection
Apple Juice
Fruit Juice
Water
Friday Entree
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No Selection
Chicken & Dumplings w/biscuit
Cheese Pizza
Pepperoni Pizza
Chicken Tenders
Friday Side Dish
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No Selection
Natural Potato Chips
Spring mix fruit
Salad
Broccoli
Friday Drink
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No Selection
Apple Juice
Fruit Juice
Water
NOTE: To ensure that your child has a meal prepared, please make selections one day in advance.
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