Student Block/Unblock Form
Dear Parent/Guardian,

The Klein Nutrition and Food Services Department can “block” a student’s purchase of à
la carte items at the cash register. An à la carte includes such items as a second meal, extra
milk, cookies, ice cream, and other snack items.

If you wish to “block/unblock” your student’s account, please fill out and submit the form below.

*Please we aware that a separate form must be submitted for each student that you would like to block/unblock
Block or Unblock *
Student Name (First Last) *
Student ID Number *
Parent/Guardian Full Name *
Parent/guardian email address *
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