FIELD TRIP REPORT (Lunchroom staff will not be able to honor request if this form is not turned in to the director three weeks in advance.) Teacher ___________________________ Grade___________ Date of fieldtrip____________

STUDENT NAME

LUNCH ACCOUNT NUMBER

MILK CHOICE

Number of adult lunches needed ___________ Number of student lunches needed ___________ Adult lunch price $3.50 Teacher’s signature _________________________ This institution is a equal opportunity provider. Copy 1 –Director Copy 2- Manager Copy 3- Manager must turn in with daily production.

LUNCH RECEIVED

Milk choice Chocolate _________ Skim _________ 1% White _________