• **Please send in this form each Monday, even if your child is bringing lunch, free/reduced, or paying with School Bucks. 

     

    Mrs. Moulton’s Class                                       Full Lunch (with milk):  $2.25

    Weekly Lunch/Milk Form                                Milk:  .50 cents

    Child’s Name __________________________

    Week of: _____________________________

    Please circle the day(s).  Lunch menu is found in the monthly school newsletter.  There is no lunch or snack milk on half days.

    Buying school lunch (with milk):           M        T          W        Th        F                                                                                                              total: ______      

    Buying only milk at lunch:           M        T          W        Th        F                                                                                                                          total: _____

    Buying milk at snack:        M        T          W        Th        F                        

                                                total:______

                                                               Total enclosed:__________________

    Checks payable to:  South Hadley School Lunch Program

    If you paid for your child’s lunch online, please write SB in Total area to indicate it is to be paid through your child’s School Bucks account.