Hot Lunch Order Form - Polson Park Public School

École Polson Park Public School
School Lunch Program
April 27, 2015
Dear Parent/Guardian:
It is time for our last School Lunch order of the year, to cover the last 7 weeks in May and June. We are
very excited to be adding Copper Penny Wraps to our menu, on June 11! Please complete the
attached order form if you would like your child to purchase a lunch on any of the Thursdays during these
six weeks. Our Lunch Menu is in compliance with the LDSB’s Nutrition Policy AP210 (Creating a Healthy
Nutrition Environment) and is based on the Eating Well with Canada’s Food Guide and the Ministry of
Education’s nutrition guidelines. Payment can be made either in cash or by cheque payable to Polson
Park P.S. Please send the correct amount, as we are unable to make change. Please note there is no
hot lunch on June 25.
Pizza from Pizza Pizza is on a whole grain crust, and is 1/8 of a large, 14” pizza.
Subs from Subway are served on a 6” whole wheat sub bun. Subs come with cheese, lettuce, and
tomato. Please indicate on your form if you do not wish to have one or more of these toppings.
Pasta from Ramekins is a serving of penne with either meat sauce or tomato sauce, served with garlic
bread.
Copper Penny’s Turkey or Roast Beef Wrap includes thinly sliced turkey breast (real breast meat) or
roast beef, wrapped & grilled in a flour tortilla with shredded lettuce, diced tomatoes, mayo & cheddar
cheese. The Sweet BBQ Wrap is breaded chicken tossed in BBQ sauce with shredded lettuce, diced
tomatoes & mayo, wrapped & grilled in a flour tortilla. The Roasted Vegetable Wrap is red peppers,
thinly sliced mushrooms, broccoli, celery, and baby spinach, wrapped & grilled in a tomato basil flour
tortilla with mozzarella cheese & roasted red pepper mayo. Please indicate on your form if you do not
wish to have one or more of the toppings.
Fruit is one piece of fruit, usually an apple or banana, based on availability.
Please Note: If paying for more than one student, please send in a separate order form for each child to
give to their homeroom teacher. Payment can be combined and sent in with only one child, if you prefer
this method of payment.
There will be no refunds for missed hot lunch days; however, we will save your child’s order for the
following day.
Proceeds from the hot lunch program will be used to help pay for our new Kindergarten Playground.
Orders are due by May 4, 2015 for this Order.
École Polson Park P.S Staff
Ecole Polson Park Public School
School Lunch Program - Order Form
Student Name:_____________________ Teacher:__________________
Check ✓
Date
Food Item
May 7
Pizza Pizza
Cheese Pizza slice
Chicken Pizza slice
Fruit
□
□
□
$2.50
$2.50
$0.50
Ramekins
Penne w. Meat Sauce
Penne w. Tomato S.
Fruit
□
□
□
$5.00
$5.00
$0.50
□
□
□
□
$5.00
$5.00
$5.00
$0.50
Pizza Pizza
Cheese Pizza slice
Chicken Pizza slice
Fruit
□
□
□
$2.50
$2.50
$0.50
Ramekins
Penne w. Meat Sauce
Penne w. Tomato S.
Fruit
□
□
□
$5.00
$5.00
$0.50
□
□
□
□
□
$5.00
$5.00
$5.00
$5.00
$0.50
□
□
□
$2.50
$2.50
$0.50
May 14
May 21
May 28
June 4
June 11
June 18
Subway
6" Turkey Sub
6" Ham Sub
6" Veggie Sub
Fruit
Copper Penny
Penny’s Turkey Wrap
Penny’s R. Beef Wrap
Sweet BBQ Wrap
Roasted Veg. Wrap
Fruit
Pizza Pizza
Cheese Pizza slice
Chicken Pizza slice
Fruit
Total payment included (Orders are due by May. 1)
Price
Total
___________
____________
_____________
_____________
____________
____________
____________
$