Breakfast & Lunch Request Form
The Julesburg School District during school closure related to the COVID-19 virus will be providing free breakfast and lunch beginning Monday, March 23rd. Grab-n-Go Style; Lunch & Breakfast (for the next morning) will be picked up at the same time at the elementary school from 11 a.m. - 12 p.m. daily (Monday - Friday). Please fill out this survey and submit no later than Friday, March 20th if you plan to participate.
BREAKFAST - Student(s) Name(s) and Grade(s): (i.e. Mary Smith, 4th Grade) (List all of your children who will need BREAKFAST):
LUNCH - Student(s) Name(s) and Grade(s): (i.e. Mary Smith, 4th Grade) (List all of your children who will need LUNCH):
By typing in my electronic signature, I will participate in the district breakfast and lunch program during the COVID-19 school closure, Monday through Friday (school days) AND I will pick up my child(ren)'s breakfast and/or lunch at the elementary school between 11:00 a.m. and 12:00 p.m. daily. *
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