Special Lunch - Culver's - September

This order form is for Special Lunch on

September 29th at Pritchett and Tripp

September 30th at Meridian and AJHS

Culver's will be providing your choice of options - see below.

Each option comes with chips & custard

Item Description Price Qty

Special Lunch - Culver's - September 2025 $9.00 Options: Butter Burger Single
ButterBurger w/ Cheese Single
Gluten Free Butter Burger Single
2 pc Chicken Tender
Grilled Cheese
Garden Salad (no meat - veggie option)

Butter Burger Single #1	Student First Name Student Last Name School (reset) Pritchett-Sept 29 Tripp-Sept 29 Meridian-Sept 30 Aptakisic-Sept 30 Homeroom/Advisory Teacher* Custard flavor (reset) Vanilla Chocolate	copy
Butter Burger Single #2	Student First Name Student Last Name School (reset) Pritchett-Sept 29 Tripp-Sept 29 Meridian-Sept 30 Aptakisic-Sept 30 Homeroom/Advisory Teacher* Custard flavor (reset) Vanilla Chocolate
Butter Burger Single #3	Student First Name Student Last Name School (reset) Pritchett-Sept 29 Tripp-Sept 29 Meridian-Sept 30 Aptakisic-Sept 30 Homeroom/Advisory Teacher* Custard flavor (reset) Vanilla Chocolate
Butter Burger Single #4	Student First Name Student Last Name School (reset) Pritchett-Sept 29 Tripp-Sept 29 Meridian-Sept 30 Aptakisic-Sept 30 Homeroom/Advisory Teacher* Custard flavor (reset) Vanilla Chocolate
Butter Burger Single #5	Student First Name Student Last Name School (reset) Pritchett-Sept 29 Tripp-Sept 29 Meridian-Sept 30 Aptakisic-Sept 30 Homeroom/Advisory Teacher* Custard flavor (reset) Vanilla Chocolate
Butter Burger Single #6	Student First Name Student Last Name School (reset) Pritchett-Sept 29 Tripp-Sept 29 Meridian-Sept 30 Aptakisic-Sept 30 Homeroom/Advisory Teacher* Custard flavor (reset) Vanilla Chocolate
Butter Burger Single #7	Student First Name Student Last Name School (reset) Pritchett-Sept 29 Tripp-Sept 29 Meridian-Sept 30 Aptakisic-Sept 30 Homeroom/Advisory Teacher* Custard flavor (reset) Vanilla Chocolate
Butter Burger Single #8	Student First Name Student Last Name School (reset) Pritchett-Sept 29 Tripp-Sept 29 Meridian-Sept 30 Aptakisic-Sept 30 Homeroom/Advisory Teacher* Custard flavor (reset) Vanilla Chocolate
Butter Burger Single #9	Student First Name Student Last Name School (reset) Pritchett-Sept 29 Tripp-Sept 29 Meridian-Sept 30 Aptakisic-Sept 30 Homeroom/Advisory Teacher* Custard flavor (reset) Vanilla Chocolate
ButterBurger w/ Cheese Single #1	Student First Name Student Last Name School (reset) Pritchett-Sept 29 Tripp-Sept 29 Meridian-Sept 30 Aptakisic-Sept 30 Homeroom/Advisory Teacher* Custard flavor (reset) Vanilla Chocolate	copy
ButterBurger w/ Cheese Single #2	Student First Name Student Last Name School (reset) Pritchett-Sept 29 Tripp-Sept 29 Meridian-Sept 30 Aptakisic-Sept 30 Homeroom/Advisory Teacher* Custard flavor (reset) Vanilla Chocolate
ButterBurger w/ Cheese Single #3	Student First Name Student Last Name School (reset) Pritchett-Sept 29 Tripp-Sept 29 Meridian-Sept 30 Aptakisic-Sept 30 Homeroom/Advisory Teacher* Custard flavor (reset) Vanilla Chocolate
ButterBurger w/ Cheese Single #4	Student First Name Student Last Name School (reset) Pritchett-Sept 29 Tripp-Sept 29 Meridian-Sept 30 Aptakisic-Sept 30 Homeroom/Advisory Teacher* Custard flavor (reset) Vanilla Chocolate
ButterBurger w/ Cheese Single #5	Student First Name Student Last Name School (reset) Pritchett-Sept 29 Tripp-Sept 29 Meridian-Sept 30 Aptakisic-Sept 30 Homeroom/Advisory Teacher* Custard flavor (reset) Vanilla Chocolate
ButterBurger w/ Cheese Single #6	Student First Name Student Last Name School (reset) Pritchett-Sept 29 Tripp-Sept 29 Meridian-Sept 30 Aptakisic-Sept 30 Homeroom/Advisory Teacher* Custard flavor (reset) Vanilla Chocolate
ButterBurger w/ Cheese Single #7	Student First Name Student Last Name School (reset) Pritchett-Sept 29 Tripp-Sept 29 Meridian-Sept 30 Aptakisic-Sept 30 Homeroom/Advisory Teacher* Custard flavor (reset) Vanilla Chocolate
ButterBurger w/ Cheese Single #8	Student First Name Student Last Name School (reset) Pritchett-Sept 29 Tripp-Sept 29 Meridian-Sept 30 Aptakisic-Sept 30 Homeroom/Advisory Teacher* Custard flavor (reset) Vanilla Chocolate
ButterBurger w/ Cheese Single #9	Student First Name Student Last Name School (reset) Pritchett-Sept 29 Tripp-Sept 29 Meridian-Sept 30 Aptakisic-Sept 30 Homeroom/Advisory Teacher* Custard flavor (reset) Vanilla Chocolate
Gluten Free Butter Burger Single #1	Student First Name Student Last Name School (reset) Pritchett-Sept 29 Tripp-Sept 29 Meridian-Sept 30 Aptakisic-Sept 30 Homeroom/Advisory Teacher* Custard flavor (reset) Vanilla Chocolate	copy
Gluten Free Butter Burger Single #2	Student First Name Student Last Name School (reset) Pritchett-Sept 29 Tripp-Sept 29 Meridian-Sept 30 Aptakisic-Sept 30 Homeroom/Advisory Teacher* Custard flavor (reset) Vanilla Chocolate
Gluten Free Butter Burger Single #3	Student First Name Student Last Name School (reset) Pritchett-Sept 29 Tripp-Sept 29 Meridian-Sept 30 Aptakisic-Sept 30 Homeroom/Advisory Teacher* Custard flavor (reset) Vanilla Chocolate
Gluten Free Butter Burger Single #4	Student First Name Student Last Name School (reset) Pritchett-Sept 29 Tripp-Sept 29 Meridian-Sept 30 Aptakisic-Sept 30 Homeroom/Advisory Teacher* Custard flavor (reset) Vanilla Chocolate
Gluten Free Butter Burger Single #5	Student First Name Student Last Name School (reset) Pritchett-Sept 29 Tripp-Sept 29 Meridian-Sept 30 Aptakisic-Sept 30 Homeroom/Advisory Teacher* Custard flavor (reset) Vanilla Chocolate
Gluten Free Butter Burger Single #6	Student First Name Student Last Name School (reset) Pritchett-Sept 29 Tripp-Sept 29 Meridian-Sept 30 Aptakisic-Sept 30 Homeroom/Advisory Teacher* Custard flavor (reset) Vanilla Chocolate
Gluten Free Butter Burger Single #7	Student First Name Student Last Name School (reset) Pritchett-Sept 29 Tripp-Sept 29 Meridian-Sept 30 Aptakisic-Sept 30 Homeroom/Advisory Teacher* Custard flavor (reset) Vanilla Chocolate
Gluten Free Butter Burger Single #8	Student First Name Student Last Name School (reset) Pritchett-Sept 29 Tripp-Sept 29 Meridian-Sept 30 Aptakisic-Sept 30 Homeroom/Advisory Teacher* Custard flavor (reset) Vanilla Chocolate
Gluten Free Butter Burger Single #9	Student First Name Student Last Name School (reset) Pritchett-Sept 29 Tripp-Sept 29 Meridian-Sept 30 Aptakisic-Sept 30 Homeroom/Advisory Teacher* Custard flavor (reset) Vanilla Chocolate
2 pc Chicken Tender #1	Student First Name Student Last Name School (reset) Pritchett-Sept 29 Tripp-Sept 29 Meridian-Sept 30 Aptakisic-Sept 30 Homeroom/Advisory Teacher* Custard flavor (reset) Vanilla Chocolate	copy
2 pc Chicken Tender #2	Student First Name Student Last Name School (reset) Pritchett-Sept 29 Tripp-Sept 29 Meridian-Sept 30 Aptakisic-Sept 30 Homeroom/Advisory Teacher* Custard flavor (reset) Vanilla Chocolate
2 pc Chicken Tender #3	Student First Name Student Last Name School (reset) Pritchett-Sept 29 Tripp-Sept 29 Meridian-Sept 30 Aptakisic-Sept 30 Homeroom/Advisory Teacher* Custard flavor (reset) Vanilla Chocolate
2 pc Chicken Tender #4	Student First Name Student Last Name School (reset) Pritchett-Sept 29 Tripp-Sept 29 Meridian-Sept 30 Aptakisic-Sept 30 Homeroom/Advisory Teacher* Custard flavor (reset) Vanilla Chocolate
2 pc Chicken Tender #5	Student First Name Student Last Name School (reset) Pritchett-Sept 29 Tripp-Sept 29 Meridian-Sept 30 Aptakisic-Sept 30 Homeroom/Advisory Teacher* Custard flavor (reset) Vanilla Chocolate
2 pc Chicken Tender #6	Student First Name Student Last Name School (reset) Pritchett-Sept 29 Tripp-Sept 29 Meridian-Sept 30 Aptakisic-Sept 30 Homeroom/Advisory Teacher* Custard flavor (reset) Vanilla Chocolate
2 pc Chicken Tender #7	Student First Name Student Last Name School (reset) Pritchett-Sept 29 Tripp-Sept 29 Meridian-Sept 30 Aptakisic-Sept 30 Homeroom/Advisory Teacher* Custard flavor (reset) Vanilla Chocolate
2 pc Chicken Tender #8	Student First Name Student Last Name School (reset) Pritchett-Sept 29 Tripp-Sept 29 Meridian-Sept 30 Aptakisic-Sept 30 Homeroom/Advisory Teacher* Custard flavor (reset) Vanilla Chocolate
2 pc Chicken Tender #9	Student First Name Student Last Name School (reset) Pritchett-Sept 29 Tripp-Sept 29 Meridian-Sept 30 Aptakisic-Sept 30 Homeroom/Advisory Teacher* Custard flavor (reset) Vanilla Chocolate
Grilled Cheese #1	Student First Name Student Last Name School (reset) Pritchett-Sept 29 Tripp-Sept 29 Meridian-Sept 30 Aptakisic-Sept 30 Homeroom/Advisory Teacher* Custard flavor (reset) Vanilla Chocolate	copy
Grilled Cheese #2	Student First Name Student Last Name School (reset) Pritchett-Sept 29 Tripp-Sept 29 Meridian-Sept 30 Aptakisic-Sept 30 Homeroom/Advisory Teacher* Custard flavor (reset) Vanilla Chocolate
Grilled Cheese #3	Student First Name Student Last Name School (reset) Pritchett-Sept 29 Tripp-Sept 29 Meridian-Sept 30 Aptakisic-Sept 30 Homeroom/Advisory Teacher* Custard flavor (reset) Vanilla Chocolate
Grilled Cheese #4	Student First Name Student Last Name School (reset) Pritchett-Sept 29 Tripp-Sept 29 Meridian-Sept 30 Aptakisic-Sept 30 Homeroom/Advisory Teacher* Custard flavor (reset) Vanilla Chocolate
Grilled Cheese #5	Student First Name Student Last Name School (reset) Pritchett-Sept 29 Tripp-Sept 29 Meridian-Sept 30 Aptakisic-Sept 30 Homeroom/Advisory Teacher* Custard flavor (reset) Vanilla Chocolate
Grilled Cheese #6	Student First Name Student Last Name School (reset) Pritchett-Sept 29 Tripp-Sept 29 Meridian-Sept 30 Aptakisic-Sept 30 Homeroom/Advisory Teacher* Custard flavor (reset) Vanilla Chocolate
Grilled Cheese #7	Student First Name Student Last Name School (reset) Pritchett-Sept 29 Tripp-Sept 29 Meridian-Sept 30 Aptakisic-Sept 30 Homeroom/Advisory Teacher* Custard flavor (reset) Vanilla Chocolate
Grilled Cheese #8	Student First Name Student Last Name School (reset) Pritchett-Sept 29 Tripp-Sept 29 Meridian-Sept 30 Aptakisic-Sept 30 Homeroom/Advisory Teacher* Custard flavor (reset) Vanilla Chocolate
Grilled Cheese #9	Student First Name Student Last Name School (reset) Pritchett-Sept 29 Tripp-Sept 29 Meridian-Sept 30 Aptakisic-Sept 30 Homeroom/Advisory Teacher* Custard flavor (reset) Vanilla Chocolate
Garden Salad (no meat - veggie option) #1	Student First Name Student Last Name School (reset) Pritchett-Sept 29 Tripp-Sept 29 Meridian-Sept 30 Aptakisic-Sept 30 Homeroom/Advisory Teacher* Custard flavor (reset) Vanilla Chocolate	copy
Garden Salad (no meat - veggie option) #2	Student First Name Student Last Name School (reset) Pritchett-Sept 29 Tripp-Sept 29 Meridian-Sept 30 Aptakisic-Sept 30 Homeroom/Advisory Teacher* Custard flavor (reset) Vanilla Chocolate
Garden Salad (no meat - veggie option) #3	Student First Name Student Last Name School (reset) Pritchett-Sept 29 Tripp-Sept 29 Meridian-Sept 30 Aptakisic-Sept 30 Homeroom/Advisory Teacher* Custard flavor (reset) Vanilla Chocolate
Garden Salad (no meat - veggie option) #4	Student First Name Student Last Name School (reset) Pritchett-Sept 29 Tripp-Sept 29 Meridian-Sept 30 Aptakisic-Sept 30 Homeroom/Advisory Teacher* Custard flavor (reset) Vanilla Chocolate
Garden Salad (no meat - veggie option) #5	Student First Name Student Last Name School (reset) Pritchett-Sept 29 Tripp-Sept 29 Meridian-Sept 30 Aptakisic-Sept 30 Homeroom/Advisory Teacher* Custard flavor (reset) Vanilla Chocolate
Garden Salad (no meat - veggie option) #6	Student First Name Student Last Name School (reset) Pritchett-Sept 29 Tripp-Sept 29 Meridian-Sept 30 Aptakisic-Sept 30 Homeroom/Advisory Teacher* Custard flavor (reset) Vanilla Chocolate
Garden Salad (no meat - veggie option) #7	Student First Name Student Last Name School (reset) Pritchett-Sept 29 Tripp-Sept 29 Meridian-Sept 30 Aptakisic-Sept 30 Homeroom/Advisory Teacher* Custard flavor (reset) Vanilla Chocolate
Garden Salad (no meat - veggie option) #8	Student First Name Student Last Name School (reset) Pritchett-Sept 29 Tripp-Sept 29 Meridian-Sept 30 Aptakisic-Sept 30 Homeroom/Advisory Teacher* Custard flavor (reset) Vanilla Chocolate
Garden Salad (no meat - veggie option) #9	Student First Name Student Last Name School (reset) Pritchett-Sept 29 Tripp-Sept 29 Meridian-Sept 30 Aptakisic-Sept 30 Homeroom/Advisory Teacher* Custard flavor (reset) Vanilla Chocolate

Special Lunch - Culver's - September 2025 $10.00 Options: 3 pc Chicken Tender

We apologize but there will be no refunds provided for absences.

PTO Refund Policy: No refunds will be given for dessert/food that has already been ordered. If dessert/food has not been ordered, a credit can be given for use on a future PTO item.