Pizza Day!

Student's name *

First Name

Last Name

MON, 1/27 (order by 5 pm 1/26)

TUE, 2/4 (order by 5 pm 2/3)

WED, 2/12 (order by 5 pm 2/11)

THU, 2/27 (order by 5 pm 2/26)

MON 3/3 (order by 5 pm 3/2)

TUE 3/11 (order by 5 pm 3/10)

WED 3/19 (order by 5 pm 3/18)

THU 3/27 (order by 5 pm 3/26)

MON 3/31 (order by 5 pm 3/30)

TUE 4/22 (order by 5 pm 4/21)

WED 4/30 (order by 5 pm 4/29)

THU 5/8 (order by 5 pm 5/7)

Parent's name *

First Name

Last Name

Parent's phone *

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Please calculate the total amount due for all pizza days selected (at $5 per day). Once you click the Order Now button, you will be redirected to the payment page where you can complete your order. *

I understand that my order is not complete until my payment is made.