
Japanese Food Lunch 
Pre-order Form 
***  Orders & Payments Due By 9:00am on Monday, January 25
th
  *** 
Students may enjoy a healthy new lunch variety from Fukuroku Sushi Express on Tuesday, February 2nd, 2016.  Meals will be 
delivered to your child’s classroom by parent volunteers.  Please see the following menu for lunch selections. 
California Rolls (8 pieces) 
Cucumber Rolls (12 pieces) 
Vegetarian Yakisoba Noodles 
Chicken Karaage (6 pieces) 
 
  Meals will be prepared by Fukuroku Sushi Express. 
  Chopsticks & cutlery will be provided. 
  Rolls include soy sauce.  Ginger & wasabi will be available upon request. 
We apologize in advance if your child’s preferred Japanese food variety is not a part of this month’s hot lunch menu. 
Thank you for your understanding 
 
 
 
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Please return this order form and payment to your child’s teacher by 9:00am on Monday, January 25, 2016. 
 
California Rolls (8 pieces) 
Cucumber Rolls (12 pieces) 
Vegetarian Yakisoba Noodles 
Chicken Karaage (6 pieces) 
                 
We have enclosed a total of $ ______________________________________________________________________ 
Students Name:  _____________________________________________________________________________ 
Division/Teacher:  _________________________________________________________________________ 
Parent’s Name:  ___________________________________________________________________________ 
Email Address To Receive Order Confirmation:  __________________________________________________ 
Additional Notes:  ______________________________________________________________________________________________________