Saxapahaw General Store Lunch Program Registration - Spring Semester 2017
(* required fields)

Student Name:*
Student E-mail:
Student Phone:
-
Parent Name:*
Parent E-mail:*
Parent Phone:*
-
Dietary preference:*
Does the student have any food allergies or other dietary restrictions?:*
If "Yes," please describe:

Choose your meal plan
(After you submit this form you will be taken to PayPal where you can pay either with your PayPal account or a credit card.)

Your lunch plan:*
Please retype this text to verify your submission:

Pin It on Pinterest

Share This