Field Trip Order Form

A minimum of a two-week notice is required for all field trip requests. All field trip meals come with:
 Peanut Butter & Jelly Sandwich, based on availability
 Fruit Selection,based on availability
 Fresh Baby Carrots
 Milk

School Name
Teachers Name
Email Address
Date of Pick-up Date of Pick-up / MM / DD YYYY
Time of Pick-up Time of Pick-up : HH MM AM/PM
Please indicate how many student bag lunches will be needed for the field trip.
Are there any students with allergies needing a bag lunch?

Are there any students with allergies needing a bag lunch? Yes No

FOOD ALLERGIES: If you have students with food allergies that will be attending this field trip it is in their best interest to bring a lunch from home. In the event that this is not possible please list the student’s name with ID number and allergy below so that the cafeteria manager can coordinate with one of the FNS Registered Dietitians to develop a meal plan for that child.
How many of the total bag lunches requested will be for allergy students? (Please list the name and student number for each allergy student needing a bag lunch in the spaces provided.)
Student Name Student Name First Last
Student Number
Food Allergy Type
Student Name Student Name First Last
Student Number
Food Allergy Type
Student Name Student Name First Last
Student Number
Food Allergy Type
Student Name Student Name First Last
Student Number
Food Allergy Type
Student Name Student Name First Last
Student Number
Food Allergy Type
Student Name Student Name First Last
Student Number
Food Allergy Type
Please upload a list of students that need Bagged Meals. Include name, student ID, and allergy(s). FNS Registered Dietitians may need to develop a meal plan for children with allergies.

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