NMS Food and Pantry Program (Neal Programa de Comida y Almacén)

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Please complete this form if you would like to pick up a food bag, school supplies or hygiene supplies. Pick up will take place at Neal Middle School - 201 Baptist Road, Durham, NC 27704. Sign-up for a pick-up slot in the form below. Please contact the school if you have any questions, 919-560-3955. (Por favor acomplete esta forma si le gustaria recojer una bolsa de comida, utiles para la escuela o productos de higiene. Lo recojeria en la Escuela Neal Middle School- 201 Baptist Road, Durham, NC 27704. Seleccione una de las horas en esta forma. Por favor contacte a la escuela si usted tiene alguna pregunta, 919-560-3955.)

Student Name (Nombre de Estudiante) *

Parent/Guardian Name (Nombre de Padre o Guardian) *

Phone Number (Numero de teléfono) *

Email (Correo Electrónico)

Student Grade Level (Nivel de Grado de Estudiante) *

6th

7th

8th

Required

I would like to pick up: (Me gustaría recoger:) *

Food Bag (Bolsa de Comida)

Bookbag/School supplies (Mochila/Útiles para la Escuela)- LIMITED NUMBER REMAINING

Required

How many people live in your household? (Cuantas personas viven en su vivienda) *

What time will you pick up your items? (¿A qué hora recogerá sus artículos?) *

9:00-9:30am

9:30-10:00am

10:00-10:30am

10:30-11:00am

11:00-11:30am

11:30-12:00pm

Unable to pick up before 12pm/incapaz de recoger antes de las 12pm

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