Kitchen Sink

Fields marked with * are required

• Student Phone Number * This field is required
  Contact phone number
• Cereals * This field is required

  
  

  • Cold Cereal
  • Hot Cereal
• Chips * This field is required

  Choose:

  • Regular
  • Baked
• Beverage * This field is required

  • Coke
  • Diet Coke
  • Sprite
  • Pepsi
  • Mountain Dew
• Sweetner * This field is required

  Choose One

  • Sugar Packets
  • Splenda Packets
• Bread * This field is required

  Choose one

  • White bread
  • Wheat bread
• Comments / Special Instructions This field is required
  Please provide any comments or instructions