Faxed___________________ 
By Friday   
( 608) 784-1112 Attn: Mr. Anderson
Student Filler: _____________________________ Date:______________
    POP | 
    
     # Of Bottles  | 
    
     Order  | 
  
    Pepsi | 
    
     5  | 
    
     
  | 
  
| 
     Mountain Dew  | 
    
     8  | 
    
     
  | 
  
| 
     Diet Pepsi  | 
    
     1  | 
    
     
  | 
  
| 
     Diet Mountain Dew  | 
    
     1  | 
    
     
  | 
  
| 
     Sierra Mist  | 
    
     1  | 
    
     
  | 
  
| 
     Mug Rootbeer  | 
    
     1  | 
    
     
  | 
  
| 
     Sunkist  | 
    
     1  | 
    
     
  | 
  
| 
     Wild Cherry Pepsi  | 
    
     1  | 
    
     
  | 
  
| 
     Pepsi Twist  | 
    
     1  | 
    
     
  | 
  
    JUICE | 
    
     # Of Bottles  | 
    
     Order  | 
  
    Tropicana Lemonade | 
    
     1  | 
    
     
  | 
  
| 
     Trop. Pink Lemonade  | 
    
     1  | 
    
     
  | 
  
| 
     Trop. Straw. Melon  | 
    
     1  | 
    
     
  | 
  
| 
     Hawaiian Punch  | 
    
     1  | 
    
     
  | 
  
| 
     Dole Apple  | 
    
     1  | 
    
     
  | 
  
| 
     Dole Orange  | 
    
     1  | 
    
     
  | 
  
| 
     Dole Grape  | 
    
     1  | 
    
     
  | 
  
| 
     Dole Lt. Berry Blend  | 
    
     1  | 
    
     
  | 
  
| 
     Iced Tea  | 
    
     1  | 
    
     
  | 
  
| 
     Gatorade Grape  | 
    
     1  | 
    
     
  | 
  
| 
     Gatorade Lemon Lime  | 
    
     1  | 
    
     
  | 
  
| 
     Gatorade Fruit Punch  | 
    
     1  | 
    
     
  | 
  
| 
     Gatorade Cool Blue  | 
    
     1  | 
    
     
  | 
  
| 
     Propel Lemon  | 
    
     1  | 
    
     
  | 
  
| 
     Propel Kiwi-Straw.  | 
    
     1  | 
    
     
  | 
  
| 
     Propel Berry  | 
    
     1  | 
    
     
  | 
  
| 
     Aquafina Water  | 
    
     5  | 
    
     
  | 
  
| 
     Aquafina Flavor Splash Raspberry  | 
    
     1  | 
    
     
  |