PIZZA LUNCH ORDER FORM

2015 - 2016

Students Name: ______________________________________________________

Teachers Name _____________________________

Room No.: __________

Please check all the dates you would like to order pizza lunch.
____Oct 29 (Thurs)

____ Nov 26 (Thurs)

____ Dec10 (Thurs)

____Jan 28 (Thurs)

____Feb 25 (Thurs)

____Mar31 (Thurs)

____ Apr14 (Thurs)

____Apr 28 (Thurs)

____May12 (Thurs)

____May 26 (Thurs)

____ June 16 (Thurs)

Please check your selection of pizza lunch

Cost

___

(1 slice)

$4.00

___

(2 slices)

$5.00

___

(3 slices)

$6.00

Please check ONE choice of pizza.

_ Cheese

_ Pepperoni

Total amount enclosed: ______ x $ ___________ = $_____________

Please return order form and payment to the school by Monday, October 19, 2015.
Cheque is the only acceptable payment method.
Please make cheques payable to Cliffwood School Council. NO CASH PLEASE!!
Post-dated cheques are NOT acceptable.

Thank you for your support.