Chick-Fil-A PRE-ORDER Lunch Form

Served Wednesday,January 31
Email Questions to HeirwayCares@gmail.com
MONEY AND COMPLETED FORMS ARE DUE TUESDAY, January 30
at 12:00pm! PRESALE ONLY-NO REFUNDS!!

Student:_______________________________________________ Grade:_________

ENTREES: QTY: PRICE PER ITEM: TOTAL:

Original Chicken Sandwich $5.50/ea

SPICY Chicken Sandwich $6.00/ea

Grilled Chicken Sandwich $6.50/ea

8 Ct. Chicken Nugget (Fried) $5.50/ea

12 Ct. Chicken Nugget (Fried) $6.50/ea

Cobb Salad W/ Nuggets* $9.50/ea

(Fried or Grilled- circle one)

Market Salad w/ Nuggets* $9.50/ea

(Fried or Grilled- circle one)*
*Salad Dressing- Choose ONE:
___Avocado Lime Ranch ___Garden Herb Ranch ___Balsamic Vinaigrette
___Lt. Italian ___ Apple Cider Vinaigrette.
SIDES/DRINKS: QTY: PRICE PER ITEM: TOTAL:
Medium FRY $3.00/ea

Small Mac N Cheese $3.50/ea

Small Fresh Fruit Cup $3.50/ea

Small Side Salad* $4.50/ea

Medium Sweet/ Unsweet Tea $2.00/ea

Plain Milk $1.00/ea

Chocolate Milk $1.00/ea

Juice Box $1.00/ea

___Avocado Lime Ranch ___Garden Herb Ranch ___Balsamic Vinaigrette
___Lt. Italian ___ Apple Cider Vinaigrette
GRAND TOTAL DUE:$_____________
Payment Option- Choose ONE:
____EXACT CASH ____Venmo @Ashley-Jordan-2730
MONEY AND COMPLETED FORMS ARE DUE TUESDAY, JANUARY 30
at 12:00pm!
PRESALE ONLY-NO REFUNDS!!