Pizza Order Form - Brownell Talbot School

Holiday Concert Pizza Order
Please Order by December 8
Yes, I would like my child to have a pizza meal before the evening
performance on December 11. The cost per order is $4.00. You
may order for multiple children by indicating the names below.
(An order will consist of two pieces of pizza of the same type,
bottled water, and a cookie. One order per student please.)
____ Pepperoni
____ Beef
____ Cheese
Student Name(s) with grade
_________________________________________________
_________________________________________________
List first and last name and grade
_____I am including the payment with the order
_____ I prefer to have the school bill our account
________________________________________________
Parent Signature