Last Name Jan. Feb. First Name . Phone# .

MISSED LUNCHES: If your student misses a hot lunch day, call Judi Phelps at the JCS office (412.561.5917) up until 9 a.m. the
day of the lunch that will be missed. We can cancel the order and issue a credit toward the next month’s order. If you don’t cancel,
we won’t issue a credit and we’ll keep the lunch in the lunch room refrigerator for one day only. FIELD TRIPS: If your student
misses a hot lunch due to a field trip, we’ll issue a credit for you to apply to the next month’s order. LATE ORDERS/
QUESTIONS: contact Susan Clellen (412.563-1515) pttsusan@verizon.net to avoid missing lunches. DON’T WANT ANY LUNCHES
AT ALL? Please return the form with “No thanks!” written on it so you’re accounted for.

Date Menu Item Amount Due

01/14/2010 General Tso’s Chicken $4.10 . Beef and Broccoli $4.10 .

Castle Place Steamed Rice . Fried Rice .
Chinese Choose one of the above lunches and type of rice. No MSG used & “not so spicy” for kids.

01/15/2010 $1.40 Plain $1.40 Pepperoni .

Vocelli’s Pizza Enter the number of items you’d like . Includes raw veggies.

01/21/2010 $3.45 . Check here if you prefer no Cheese .

Carbonara’s Includes baked ziti with tomato sauce and melted provolone and raw veggies.

01/22/2010 $1.20 Plain $1.20 Pepperoni .

Papa John’s Enter the number of items you’d like . Includes raw veggies.
1/28/2010 $3.55 .
Chic Fil-A Fried chicken sandwich (in refined peanut oil). Includes raw veggies and potato chips

01/29/2010 $1.40 Plain $1.40 Pepperoni .

Vocelli’s Pizza Enter the number of items you’d like . Includes raw veggies.

02/4/2010 General Tso’s Chicken $4.10 . Beef and Broccoli $4.10 .

Castle Place Steamed Rice . Fried Rice .
Chinese Choose one of the above lunches and type of rice. No MSG used & “not so spicy” for kids.

02/5/2010 $1.20 Plain $1.20 Pepperoni .

Papa John’s Enter the number of items you’d like . Includes raw veggies.

02/11/2010 $3.55 .
Chic Fil-A Fried chicken sandwich (in refined peanut oil). Includes raw veggies and potato chips

02/12/02 No School Teacher in Service Day

Total:

Help us treat our teachers and staff to lunch! Optional “Feed Your Teacher” Contribution:

Make check payable to JCS, attach to this lunch order and return to the office. Grand Total: