Smile Gram Parent Order Form
Smile Grams will be sold on May 10th and 11th. If you would like to order a Smile Gram to send
to a student please complete this Order Form AND a Smile Gram Message from the sheet
below. A completed Parent Order Form must accompany the Gram Message being sent to a
student. If you want to send more than one Gram Message to the same student, you can just
complete one Parent Order Form and the multiple Gram Messages for that one student. If you
want to send Gram Messages to more than one student then you’ll need to complete a Parent
Order Form and a Gram Message for each student you want to send items to. Please put the
completed forms and your payment in a sealed envelope, marked “PTO Cafeteria Sales”.
Please have one envelope for each student you are sending Grams to. Send the envelope to
school with your child to give to their teacher and turn into the office.
All orders must be received at school no later than May 9th; Gram orders cannot be
processed after that time.
PLEASE PRINT
Student’s first name: ____________________ Student’s last name: ____________________
Homeroom class: _____________________________________________________________
Parent’s name: _______________________________________________________________
*We will try our best to fulfill your color, style or flavor preference but the items are based on availability
and can’t be guaranteed.
NOVELTY ITEMS
COLOR / STYLE CHOICE – please circle
QUANTITY PRICE
bouncy ball
eraser
popper
vinyl pencil pouch
vinyl kick ball
inflatable beach ball
pencil sharpener
Scented Smencils
plush pal
foam water soaker gun
CANDY
Double Bubble Bubble Gum
Sour patch kid
Airhead
chocolate bar (Fun Size)
Pixie Stix – 3 pack
Suckers
Airhead Xtremes Sour Candy
full size chocolate bar
M & M pack
Sour Punch Straws
50¢
50¢
75¢
75¢
75¢
$1.00
$1.00
$1.00
green, orange, pink, yellow
blue, green, red, yellow
blue, green, yellow
black cherry, bubble gum, cinnamon, cotton candy, grape,
orange, root beer, tropical blast, very berry, watermelon
blue, green, orange, purple, red , yellow
green, orange, purple, red, yellow
COLOR / FLAVOR CHOICE - please circle
QUANTITY
Milky Way, Snicker, 3 Muskateer
Blow Pop, Ring Pop
Rainbow Berry Sour
Hershey Bar, Kit Kat, Milky Way, Nestle Crunch, Twix
green apple or strawberry
TOTAL
Please send exact change or if paying by check make payable to “Windsong PTO”.
$2.00
$2.00
PRICE
25¢
25¢
50¢
50¢
50¢
50¢
$1.00
$1.00
$1.00
$1.00
$
Smile
Be Happy
List first and last name.
List first and last name.
To:
To:
Teacher:
Teacher:
From:
From:
Message:
Message:
Have a nice day
Stay Cool
List first and last name.
List first and last name.
To:
To:
Teacher:
Teacher:
From:
From:
Message:
Message: