Northern Burlington School District COVID-19 School Closure Meal Request Form
***June 8th will be last day for Lunch Distribution.

Have a Safe and relaxing Summer!

Congratulations Class of 2020

Thank you

***To find the closest feeding site near you, text FOOD to 877-877 or Summer Meals to 97779
Finder websites: www.foodpantries.org www.fns.usda.gov/summerfoodrocks
Parent/Guardian FULL Name: *
EXAMPLE: Jane Smith
Parent/Guardian Email: *
Parent/Guardian Phone Number: *
EXAMPLE: 555-555-5555
Which school(s) does your child(ren) attend? *
Please check one or both boxes where applicable
Required
What day will you be picking up the meal? *
Please select the pick-up day! You may order ahead for upcoming weeks. You can do this by clicking the link to submit another response AFTER you submit this meal request. So, you need to fill out the form for each day you plan to pick up meals.
I agree that orders placed for MONDAY must be placed by 8 am Monday. *
Please type your students' name, grade and ID number. For multiple students please hit enter after each student's entry. *
EXAMPLE: Mike Smith- 7th- 12345, Megan Smith- 9th- 67891, Brian Smith- 12th- 34567
Any other comments:
Submit
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