Sack Lunch Request Form

Fifteen business days are required when ordering sack lunches for field trips and other school related events. The time is
needed for food and supplies to be ordered and prepared for on-time delivery.

Complete the form below and submit to your School Nutrition Manager

Today’s Date: 9/8/2022

School: North Clayton High

Person Requesting Meals: Mrs. Yancey (Art Teacher) Contact No. 404-932-2581

Grade Level(s): 9th-12th

Date of Field Trip or Event: 11/30/22

*Number of student lunches: 30 Pick-up Time: 8:45

Number of adult lunches: Adult Meal Prices - Breakfast $3.00 Lunch $4.75
(Adults must pay the cashier or nutrition manager for breakfast and/or lunch at the time of service)

SACK LUNCH ENTRÉE OPTIONS

Check sandwich choice (one sandwich choice for all participants)

Check one Sack Lunch Entrée # of lunches needed

✔ Deli Turkey & Cheese Sandwich

Deli Turkey Ham & Cheese Sandwich

PBJ Twin Pack

Sack lunch Includes;

1 Fresh Fruit of the Day
2 Fresh Vegetables (Carrot Sticks & Celery Sticks)
1 bag of Chips
1 carton of Milk

*Are there students with food allergies? If so, notify manager for an alternative meal.

Field Trip Facilitator Signature: Mrs. Yancey

Revised 1/7/2020
 (My signature states that I understand that meals must be consumed or discarded after 4 hours when not held under
proper refrigeration.)

Revised 1/7/2020