The dates for pizza day are: September 21, October 19, November 16, December 14, January 18, February 15, March 14, April 18, May 16.

Determine the number of pizza days remaining and enter below.

Family Name

Student Name	Grade and Room	Slices of Cheese (new amount)	Slices of Sausage (new amount)

Total Order Information

Original # cheese

Original # sausage

slices of cheese added @ 1.40 per slice X = $

slices of sausage added @ 1.65 per slice X = $

Total cash or check payable to St. Mary PIE $

Any questions or problems, please call Nella Urtis( 447-8431 )