Milk Order

Milk Order Form

Please use this form to order milk for your student(s) for the year.

Student Name 1

First Last

Student 1 Grade

Student Name 2

First Last

Student 2 Grade

Student Name 3

First Last

Student 3 Grade

Student Name 4

First Last

Student 4 Grade

Milk orders

Price: $16.00

Enter the number of milks for each day. Cost is $16.00 per year per student

Total

Credit Card

Card Details

Cardholder Name

Parent/Guardian Email(Required)

Billing Address(Required)

Street Address Address Line 2 City State ZIP Code