Lunch Account Restriction Form

In order to improve the efficiency and accuracy of the lunch line, modifications are being made to the notes portion of your child’s lunch profile.  If you would like to place restrictions on your child’s account, you may choose from the following options:

1-Daily lunch only
2-No a la carte purchases
3-A la carte items allowed on ______________ (specify day of week)
4-No second meal 
5-Second meal allowed on ______________(specify day of week)

Daily Lunch

Daily lunch includes:

• An entrée (contains 2 oz of protein)
• Two Servings of fruit and or vegetable (one fruit serving may be a 4-oz juice)
• Bread or Roll
• 8 oz Milk

A La Carte Items

Snack options vary from school to school based on age, however, common snack items include:

• Baked Chips
• Fruit Snacks
• Yogurt
• String Cheese
• Cookies
• Ice Cream
• Specialty Drinks

If you would like your child to purchase a snack once per week, please indicate a specific day.

 We cannot enforce a limited quantity of a la carte items purchased per day.  Our computer system cannot recognize if a prior purchase has been made that day.  

Second Meal

Students with money in their account or cash may purchase a second entrée. 

Name of Child:____________________________________________      Grade:____________________
You are not required to return this form, however, the absence of a note is indicative of no limitations on your child’s account and they will be allowed to purchase what they choose.  It is important to have a discussion with your child regarding what and when they are allowed to purchase items in the cafeteria. 
 

School:__________________________________________________      Option:____________________

Parent Signature:__________________________________________      Date:_____________________