Remote Meal Ordering Form

SEBRSD will be providing FREE Breakfasts and Lunches to all students!
Meals can be pickup at all schools in the district on Mondays and Wednesdays.

PICK UP MEALS AT KITCHEN BACK DOORS!

Knox Trail Middle School 10-1

East Brookfield Elementary School 10-12

Remote meals will be picked up in bulk and ordered on the Google Form Link
Monday for Monday- Wednesday
Wednesday Thursday and Friday

***Please fill out the form below***

Family name for pick-up *

Days of the week ordering for *

Monday

Tuesday

Wednesday

Thursday

Friday

Required

Number of students receiving meals each day (number of students in household) *

Child

Childern

REMOTE Pick-up location *

ONLY--Knox Trail Middle School (10am-12pm) MONDAY (Meals for M-W)

ONLY--Knox Trail Middle School (10am-12pm) WEDNESDAY (Meals for T-F)

BOTH Knox Trail Middle School (10am-12pm) MONDAY & WEDNESDAY (Meals for M-F)

ONLY--Wire Village Elementary School (11am-1pm) MONDAY (Meals for M-W)

ONLY--Wire Village Elementary School (11am-1pm) WEDNESDAY (Meals for T-F)

BOTH Wire Village Elementary School (11am-1pm) MONDAY & WEDNESDAY (Meals for M-F)

ONLY--East Brookfield Elementary School (12:15pm-1:15pm) MONDAY (Meals for M-W)

ONLY--East Brookfield Elementary School (12:15pm-1:15pm) WEDNESDAY (Meals for T-F)

BOTH East Brookfield Elementary School (12:15pm-1:15pm) MONDAY & WEDNESDAY (Meals for M-F)

ONLY--David Prouty High School (10am-12pm) MONDAY (Meals for M-W)

ONLY--David Prouty High School (10am-12pm) WEDNESDAY (Meals for T-F)

BOTH David Prouty High School (10am-12pm) MONDAY & WEDNESDAY (Meals for M-F)

HYBRID- Meals brought home on Thursday for Friday *

YES- Wire Village

YES- East Brookfield Elementary

YES- Knox Trail Middle

YES- David Prouty High School

NONE

Dietary restrictions with doctors note provided to nurse

Vegetarian or Gluten Free meal required?

Yes- V

Yes- GF

Clear selection

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