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Victory Life Academy & Child Care Center

School Lunch Order Form

Please use a separate form for each student.

WEEK OF:______________________________

STUDENT NAME:______________________________

Please check the days your student will be purchasing hot lunches through the school.

__________Monday

__________Tuesday

__________Wednesday

__________Thursday

__________Friday

Price:

• $2.50 for 2 year old - 4th grade.
• $2.75 for 5th grade - 12th grade.

Total:__________

Paid:__________