Last Name: The cost for Milk or Orange Juice for the school year is

Last Name:_______________________________________
2016-17 MILK, JUICE & ICE CREAM
If you participate by purchasing milk for your child(ren), they
are entitled to orange juice on Tuesdays and Thursdays.
The cost for Milk or Orange Juice for the school year is $100.
For the 2016-2017 school year we will have 8 Rosh Chodesh months that we will be serving ice cream.
Wednesday, November 2, 2016 - Cheshvan
Friday, December 2, 2016 - Kislev
Friday, December 30, 2016 - Tevet
Monday, January 30, 2017 – Shevat
Monday, February 27, 2017 – Adar
Wednesday, March 29, 2017 – Nisan
Wednesday, April 26, 2017 – Iyar
Friday, May 26, 2017 - Sivan
Make one check payable to RPRY for milk, juice and ice cream.
Do not include payments for PTA Dairy lunches on the same check.
Child’s First Name
Grade
1% Low
Fat Milk
Orange
Juice
Flying
Saucer
Ice Cream
$100.
$100.
$16.00
Ice Cream
Cup with
Sprinkles
$16.00
Total:
Total of all columns: __________________
ORDERS WITHOUT PAYMENT WILL NOT BE PROCESSED.