Glazed Pork Chop With Peas ‘n Rice

Child Information

Child Name:

Grade Level: Pre-K - Lower SchoolKindergarten - Lower SchoolGrade 1 - Lower SchoolGrade 2 - Lower SchoolGrade 3 - Lower SchoolGrade 4 - Lower SchoolGrade 5 - Lower SchoolGrade 6 - Upper SchoolGrade 7 - Upper SchoolGrade 8 - Upper SchoolGrade 9 - Upper SchoolGrade 10 - Upper SchoolGrade 11 - Upper SchoolGrade 12 - Upper School

Food Allergies

Allergies? — Select — No Yes

If yes, please describe:

Order Comments (optional; special notes for this item)

If ordering for multiple children, please place separate orders per child.