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Student:
_______________________
Week of: __________________
Teacher: Mrs.
Helms
Classroom: _________________
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(Circle
Days)
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Price
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Quantity
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Total
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Milk
(White)
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M
T W R F
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$0.50
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x
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__________
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=
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$_____________
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Milk(Choc)
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M
T W R F
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$0.50
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x
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___________
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=
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$_____________
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Juice
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M
T W R F
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$0.75
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x
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___________
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=
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$_____________
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Fries |
M T
W R F
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$1.00
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x
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__________
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=
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$_____________
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Hot Dog |
M T W T F
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$2.00
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x
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__________ |
=
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$_____________ |
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Hamburger |
M T W T F |
$2.00 |
x
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__________
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=
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$_____________ |
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Hot
Dog/ Fries
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M T W T F |
$3.00 |
x
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___________ |
=
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$_____________ |
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Hamburger/Fries
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M T W T F |
$3.00 |
x
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___________ |
=
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$_____________
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Pizza/Fries |
M T W T F |
$3.00 |
x
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___________ |
=
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$_____________
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Pizza
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M T W T F
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$2.00
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x
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___________ |
= |
$_____________
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Total
Payment
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$_____________
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