Printed fromSolonChabad.com

ב"ה

Lunch Order Form & Menu

Preschool Lunch Order Form
Preschool Pricing (Set for entire school year)

1 day / week- $234

2 days / week- $468

3 days / week- $702

4 days / week- $936

5 days / week- $1170

*Lunch Drop-In Price - $8.00
Child 1
Full Name*
First Name Last Name
Child's Teacher*
Does your child have any food allergies? If so, Please List:
Which Days?

MondayTuesdayWednesdayThursdayFriday
# Of Days / Week:*
Total: *
$
Child 2
Full Name
First Name Last Name
Child's Teacher
Does your child have any food allergies? If so, Please List:
Which Days?

MondayTuesdayWednesdayThursdayFriday
# Of Days / Week:
Total:
$
Processing Information
Mother's Name
First Name Last Name
Father's Name
First Name Last Name
Phone Number*
E-mail
Amount to Charge Today:
$
Payment

Credit CardCheck, or Other
Notes
My Billing Address is the Same as My Home Address

YesNo

Payment

Credit Card

We accept Visa, MasterCard, American Express, Discover
Credit Card Number	Security Code
Name on Card
Expiration Month	Expiration Year

Billing Address

Street Address

City

State / Province

Postal / Zip Code

Country

Total

$0.00
Should be Empty:

This page uses TLS encryption to keep your data secure.

Programs