Enter any additional information here. MSD BOONE TOWNSHIP Sack Lunch / Lunch-To-Go Request Form Please complete and turn Into your teacher within 48 HOURS of the Field Trip. Please call (219)996-4771 ext. 107 with any questions. Thank you. Students Name: ___________________________________________ Teacher/Grade: ____________________ (For Staff Use) Student Acct #______________________ ELEMENTARY……..$2.50 MIDDLE SCHOOL………….$2.75 HIGH SCHOOL…………$2.75 The cafeteria is offering to the busy and working parents an option to order a Sack Lunch for field trips. If a student qualifies for meal assistance, the Sack Lunch will count towards your student’s account as a compliant lunch. For those not receiving assistance, the Sack Lunch will be charged to their account just as if they were eating in the cafeteria. A la Carte’ items are an additional fee to ALL students. As always, parents have the option to send a sack lunch from home for all field trips. THANK YOU! MENU CHECK the box next to your preferred choice. All meals served with a napkin. Entrée Choices (Choose One) Cold Ham & Cheese on a Deli Bun Cold Turkey & Cheese on a Deli Bun Tossed salad w/Ranch Dressing (Fork included) Side Choices (Choose Two) Carrot Stix Apple Whole Grain Chips Beverage Choices (Choose One) Apple Juice Orange Juice 8 oz. Bottled Water A la Carte’ for additional fee to all students. 20 oz. Aquafina $1.50 ea Fruit Rollup $.50 ea Cookie $.50 ea Enter any additional information here. THANK YOU! (Staff will attach slip to Sack Lunch)………………………………………………………………………………………………………………...................................... Student Name _______________________ Teacher ________________