LaFollette Square 3Dinner Sack Meal Form

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Burris Laboratory School

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Ball State University Dining
Carmichael Hall
Room 140
Muncie IN 47306
Phone: 765-285-1967
Fax: 765-285-3713
athome@bsu.edu

Hours: ADMIN OFFICE
8:00 a.m. - 5:00 p.m.
(Fall····Spring)
7:30 a.m. - 4:00 p.m.
(Summer)

LaFollette Square 3Dinner Sack Meal Form

eOrder Form for a Sack Meal

Dinner Meal Equivalency = $7.30 (Fall and Spring 2008-9) If items ordered exceed this amount, overage will need to be paid with Dining Plus, Cardinal Ca$h, or when sack meal is picked up with cash, personal check, or credit card.

Items with an * indicate a required field.

Date needed *
Time of day you will pick up/pay for your meal? *
First Name *
Middle Initial *
Last Name *
Address Line 1 *
Address Line 2
Phone *
Email *
Fruit and Juice	Mixed Fruit Cup 99¢ Applesauce Cup 50¢ Apple, Whole 50¢ Orange, Whole 50¢ Banana, Whole 50¢
Eggs and Dairy	Silk Soy Milk, Vanilla $1.99 Silk Soy Milk, Chocolate $1.99 Silk Soy Milk, Regular $1.99 Milk, 2% 1 pint $1.09 Milk, Skim 1 pint $1.09 Milk, Chocolate 1 pint $1.09
Entree	Tuna Salad on Wheat Bread $1.95 Tuna Salad on White Bread $1.95 Egg Salad on Wheat Bread $1.75 Egg Salad on White Bread $1.75 Ham & American Cheese on Bun $1.95 Garden Chef Salad $3.50 (select dressing in condiments)
Side Items	Carrots & Celery Sticks $1.75 Potato Chips 99¢ BBQ Potato Chips 99¢ Baked Lays Potato Chips 99¢ Little Debbie Cakes 50¢ Little Debbie Oatmeal Pie 50¢ Little Debbie Nutty Bar 50¢
Beverages	Evian $1.50 Coke 20 oz $1.30 Diet Coke 20 oz $1.30 Sprite 20 oz $1.30 Mountain Dew 20 oz $1.30 Diet Mountain Dew 20 oz $1.30
Condiments	Catsup n/c Mustard n/c Miracle Whip n/c Mayonnaise n/c Salt packet n/c Pepper packet n/c Sliced Tomato n/c Leaf Lettuce n/c Catalina Dressing n/c Ranch Dressing n/c Ranch Lite Dressing n/c Italian Dressing n/c Italian Lite Dressing n/c
If meal exceeds $7.30, overage on....?	Dining Plus Cardinal Ca$h Cash (payable at pick up) Personal Check (payable at pick up) Credit Card - Visa or MasterCard (payable at pick up)
Comments and special instructions


Pick up your meal in Out of Bounds

Substitutions may be made if the dining unit is 'out of stock' for an item you have requested.