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Deer Isle-Stonington Elementary School
Breakfast/Lunch & Milk Order


Week of __________________to ____________________

Child’s Name____________________________________

Teacher’s Name_____________________Grade________

Breakfast (served with juice and milk) Lunch (served with milk)
Regular - $1.00 per day Regular - $1.50 per day
Reduced - 30¢ per day Reduced - 40¢ per day

Cold Lunch Milk or Extra Milk
25¢ each

Please circle the days that your child is purchasing
breakfast, lunch or milk:

Breakfast: M T W TH F

Lunch: M T W TH F

Milk: M T W TH F

Total Money Enclosed:____________

PLEASE NOTE
- This slip and payment must be returned on MONDAY (or the first
school day of the week)..
- Make sure the envelope you use has your child’s name and their teacher’s
name written on the front of it.


PLEASE DO NOT PUT BUS NOTES IN
YOUR CHILD’S LUNCH ENVELOPE!

*********************************************************
Kitchen Staff Use Only:

Credit:_____________ Owed:_____________


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