To order, place an “X” in front of the items you wish to order.                         

Please obtain teacher’s permission before ordering.

Orders must be placed one week prior to the event.

• Giant Party Cookie                                                                    

_______ Reduced Fat Otis Spunkmeyer Cookie $7.50 per cookie Serves up to 12 students.

               Customized with any greeting

• Cupcake Chocolate or Vanilla 1.5 oz Whole Grain Individually Wrapped

_______ Super Bakery Whole Grain Cupcake 1.5 oz. individually wrapped $11.00 per dozen

• Fresh Vegetable Tray

_______ Assorted Fresh Vegetables & Low-Fat Ranch Dip $12.00 per tray

• Beverages -- Snack                                                                              

_______ Fat-Free Milk or Fat-Free Chocolate Milk ----- $0.50 each

_______ 8 oz Bottled Water----------------------------------- $0.60 each

_______ 100% Juice Cup -------------------------------------$0.45 each

_______ .5 oz Rold Gold Pretzel ----------------------------$0.45 each

Number of students in the class __________

Date of Delivery ________________________

School location_________________________

Classroom ____________________________

Time _____________________________

 Indicate the greeting on the giant cookie:

_________________________________________________________________

Ordering Instructions:

Please confirm the arrangements with the teacher.

After selecting the items desired, return this form to the teacher along with full payment.

 Checks should be payable to the Hazleton Area Cafeteria Fund.

Your contact information if we have any questions.

Name: _________________________________Phone _________________________

Any questions?

Please contact

 Maria Yeselski at 570-459-3111 ext. 3190 or: yeselskim@hasdk12.org