Edible Treat Request

Return this portion to the classroom teacher

THIS FORM MUST BE SUBMITTED AT LEAST 48 HOURS PRIOR TO THE DATE OF THE TREAT

Student Name  ____________________________________Homeroom/section ______

Telephone number(s): ____________________________________________________ 

Date of Request: ____________________________________

Date of Treat: ______________________________________

List of ingredients: ________________________________________________________________________

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Parents will only be contacted if there is a problem with the snack ( i.e. contains a food ingredient  not permitted in the class due to allergy) to let them know that the proposed snack/treat is not allowed to be distributed to the class.