test Please enable JavaScript in your browser to complete this form. - Step 1 of 3School Name *School Phone Number *Teacher's Name *FirstLastCell Phone *Email *Address *Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeDate / Time *Pick Up Time *10:00 AM10:20 AM10:40 AM11:00 AM11:20 AM11:40 AM12:00 PM12:20 PM12:40 PM1:00 PM1:20 PM1:40 PM2:00 PM2:20 PM2:40 PM3:00 PMNextBoxed Lunch SelectionsStudent Boxes: $5.95 each 1/2 pressed Cuban sandwich (ham, salami, roast pork, Swiss cheese, pickle, mustard), Apple, chocolate chip cookie, bottled water. Price $5.95 Quantity Peanut butter & jelly on white bread, Apple, chocolate chip cookie, bottled water. Price $5.95 Quantity Ham & American cheese on Cuban roll, Apple, chocolate chip cookie, bottled water. Price $5.95 QuantityAdult Boxes: $11.95 each Pressed Cuban sandwich (ham, salami, roast pork, Swiss cheese, pickle, mustard), Fresh fruit salad, plantain chips, chocolate chip cookie, bottled water. Price $11.95 Quantity Grilled eggplant w/ roasted red peppers, provolone, lettuce, tomato & pesto mayo on ciabatta roll, Fresh fruit salad, plantain chips, chocolate chip cookie, bottled water. Price $11.95 Quantity Grilled chicken w/ peppers, onions, black olives, lettuce, tomato, cucumber and feta in a flour tortilla with herbed cream cheese spread, Fresh fruit salad, plantain chips, chocolate chip cookie, bottled water. Price $11.95 QuantityPreviousNextStudent Lunch Total$ 0.00Adult Lunch Total$ 0.00Total (Before Tax)$ 0.00Is your school/organization tax exempt? *YesNoFull payment is due on the day of your field trip, and must be separate from your field trip admission payment. What method of payment will you use for your boxed lunch order? *Check (Payable to the Columbia Cafe)Credit CardCashPreviousNameSubmit