Refund request from SSC Food Service
This form is for those who need to request a refund from our district's food service due to our new free lunch policy for grades K-8
Which student(s) are you requesting a refund for? *
Your answer
Which school does your student(s) attend?
Cardinal Elementary
Dakota City Elementary
Lewis and Clark Elementary
Covington Elementary
E.N. Swett Elementary
Harney Elementary
Middle School
Student 1
Student 2
Student 3
Student 4
Why are you requesting a refund? *
Parent/Guardian E-signature (Type Full Name) *
Your answer
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