2008-2009 Middle School Friday Lunch Order Form

This year, we will be using Taco Time and Pizza Pipeline (pizza, subs & pasta) for our Friday lunches. In order to continue to offer the convenience of having restaurant lunches delivered each Friday, we are simplifying the ordering process. We have chosen restaurants in close proximity to the school to help with on-time deliveries, minimized the food choices to the most popular items, and are taking orders for the entire school year instead of sending home monthly order forms. Note: There are no refunds for missed lunches due to absences, however for Friday field trips, we will make every effort to deliver the lunches to the field trip location, or apply the prepaid amount toward any meal to be purchased on the field trip.

If you would like to take advantage of the Middle School Friday Lunch Program, please make your selections below and submit this form no later than Friday, September 19th. *Please refer to the Friday Lunch Calendar on the website's Homer page for specific dates. Thank-you!

Required fields are in bold.

Student Information

First Name:

Last Name:

Current Grade:

Mark the box to indicate your choice for each restaurant you would like to order from:

Taco Time:

$3.50 X 6 = $21.00

soft taco (beef, lettuce, cheese)
soft bean and cheese burrito
*Also includes mixed fruit cup and crustos

Deselect Tacotime

Pipeline Subs:

$3.50 X 6 = $21.00

turkey and american cheese on wheat with tomatoes and lettuce.
ham and Swiss on white bread with tomatoes and lettuce.
*Also includes chips and a cookie. Mayonnaise, mustard, and Dijon on the side.

Deselect Pipeline Subs

Pipeline Pasta:

$3.50 X 6 = $21.00

spaghetti with meat sauce
macaroni and cheese
*Also includes 2 garlic breadsticks

Deselect Pipeline Pasta

Pizza Pipeline Pizza:

$3.50 X 6 = $21.00

Select the number of slices you’d like:
Pepperoni pizza slices:	1	2	3	4
Cheese pizza slices:	1	2	3	4

Deselect Pipeline Pizza

*Total for all 4 restaurants is $84.00

Parent Information

First Name:

Last Name:

Address:

City:

State:

Zip Code:

Phone:

Email:

*Your total order will be billed to your student account.