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Milk Order Form

- Important Forms
  - Milk Order Form
Contact Us
- Kate Kehrig
  
  Administrative Assistant
  
  585-586-6968
  kate.kehrigdor.org

Milk will be available for purchase to all students during the second semester. Distribution begins Monday, February 5, 2018. Because we participate in the Special Milk Program, only fat-free (skim) milk and low-fat (one percent) milk may be offered. The cost for skim white, 1% white and low fat (1%) chocolate milk for this semester will be:

Amounts listed are determined by NYS Component pricing.
	Skim	1% White	Low Fat Choc.
PreK 3 (T, Th)	$8.25	$8.75	$8.25
PreK 3 (M, W)	$7.75	$8.00	$7.75
PreK 3 (M, W, F)	$11.00	$11.25	$11.00
PreK 4 (3-day)	$11.00	$11.25	$11.00
PreK 4 (5-Day)	$19.50	$20.00	$19.50
K - 6	$19.75	$20.50	$19.75

Please return your order to the school office by Wednesday, January 24, to allow time for processing. Any families who wish may apply for free milk. Please call the office for information and forms which will then be sent home with your oldest child. You may use the form below to sign up or decline the milk program. Please total up your milk order for all of your children and put that amount in the "Total Cost" field. You have the option of paying by check or credit card once you click on "Proceed to Payment".

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- Family Name REQUIRED Please fill out this field. Please enter valid data.
- Students REQUIRED Please fill out this field.
  
  Student 1
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Grade REQUIRED Please fill out this field.
  
  Milk Type REQUIRED Skim 1% White Low Fat Chocolate NO MILK Please fill out this field.
  
  Student 2
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Grade REQUIRED Please fill out this field.
  
  Milk Type REQUIRED Skim 1% White Low Fat Chocolate NO MILK Please fill out this field.
  
  Student 3
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Grade REQUIRED Please fill out this field.
  
  Milk Type REQUIRED Skim 1% White Low Fat Chocolate NO MILK Please fill out this field.
  
  Student 4
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Grade REQUIRED Please fill out this field.
  
  Milk Type REQUIRED Skim 1% White Low Fat Chocolate NO MILK Please fill out this field.
- Total Cost REQUIRED
  Please add up the amounts and put the overall total here.
  $ Please fill out this field. Please enter a positive decimal.
Total: $

Submit

Proceed to Payment