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NAME__________________________________				SAT		SUN
	(PLEASE PRINT)


Select one type of bread
			White Bread	________		________
			Wheat Bread	________		________

Select one type of meat
			Ham	________		________
			Turkey	________		________

Select one type of cheese
			American	________		________
			Swiss	________		________

Select All that apply
			Mustard	________		________
			Mayo	________		________
			Ketchup	________		________

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