School Meal Selection Form

Student Name

First NameLast Name

Grade / Class

Parent or Guardian Email

example@example.com

Standard Lunch

Includes main dish, side, fruit, and milk.

$5.00Quantity

Vegetarian Lunch

Meat-free main dish, side, fruit, and milk.

$5.00Quantity

Gluten-Free Lunch

Gluten-free main, side, fruit, and milk.

$5.50Quantity

Vegan Lunch

Plant-based main, side, fruit, and juice.

$5.50Quantity

Total

Days of the Week Meals Needed

Preferred Meal Time

Dietary Restrictions or Allergies

Emergency Contact Name

First NameLast Name

Emergency Contact Phone

Please enter a valid phone number.Format: (000) 000-0000.

Special Instructions