Sign Up for Lunch Box Program

Please Note: all fields are required unless labeled otherwise.

Please check all fields for errors.

• Account Info

  • First Name

    This field is required

  • Last Name

    This field is required

  • Email

    This field is required

    There is already an account registered with this email

  • Username

    This field is required

    There is already an account registered with this username

  • Password

    The password must meet the requirements below

    Your password should be at least 8 characters long and include capital letters, numbers, and/or symbols.

  • Confirm Password

    The password must match

• Personal Info

  • Address

    This field is required

  • Address Line 2 (Optional)
  • City

    This field is required

  • State   Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Washington, D.C.

    This field is required

  • Zip Code

    This field is required

  • Phone Number

    This field is required

• Student Info:

  • Your Student's First Name

    This field is required

  • Your Student's Last Name

    This field is required

  • Your Student's School Select your student's school Baltimore LabCathedralGoddard School Of Owings MillsImmaculate ConceptionImmaculate Heart of MaryMercy High SchoolSevern SchoolSt. AugustineSt. CasimirSt. John`s HydesSt. Joseph'sSt. LouisSt. MarksSt. PiusxSt.James AcademyTest School MenuTrinity School

    This field is required

  • 
    Your Student's Teacher Please select a school first

  Add Another Student
• Billing Info

  • This field is required

  • This field is required

  • This field is required

  • This field is required

  • This field is required

  • Use personal address as billing address
    Billing Address

    • Address

      This field is required

    • Address Line 2 (Optional)
    • City

      This field is required

    • State   Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Washington, D.C.

      This field is required

    • Zip Code

      This field is required

    • Phone Number

      This field is required

  • Enable balance auto-refilling

    If your balance drops below $10, we'll automatically charge your credit card for the amount specified below.

  • Refill Amount

    This field is required and must be at least $20