FREE MEALS FOR KIDS

We are excited to offer a weekly meal box containing food for 7 breakfasts and 7 lunches for children 18 and under. The boxes will be available for pick-up on Wednesdays, July 30, August 6, and August 13 at the Intervale Center, 180 Intervale Rd, Burlington.

Please take a few moments to complete the survey below. It should only take a few minutes of your time. Thank you for helping us improve our services and support your family during the summer months!

Email *
Would you be interested in receiving a weekly meal box that contains 7 breakfasts and 7 lunches? *
  How many children (18 and under) in your household would be receiving meal boxes?   *
Required
On which of these dates do you think you would pick up boxes of food at the Intervale Center?  (Please select all that apply) *
Required
Do your children have any special dietary needs? *
  Would you like to receive additional information about this program or future distributions?  We will send email reminders as we get closer to the distribution date.   *
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Burlington School District.

Does this form look suspicious? Report

Google Forms