Chillicothe R-II Free Meal Request Form
Please fill out this form (one time) if you are requesting district-provided meals from the dates March 18-April 3rd. The current day's lunch and the next day's breakfast will be available daily Monday-Friday. These are available to any person 18 years and under residing in the Chillicothe R-II School District. This program is run in cooperation with the Department of Health and Senior Services. *Disclaimer these meals are not regulated by dietary restrictions. i.e. gluten-free, nut-free
Name of person requesting meals. *
Your answer
Contact Information (phone number) *
Your answer
Address (Include street address and city) *
Your answer
The total number of student meals requested per day. *
Your answer
Pick up or Delivery
Pickup Location
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