Breakfast and Lunch Order Form for Remote Learners
We are pleased to announce that the United States Department of Agriculture (USDA) has extended a program allowing us to offer free breakfast and lunch to all Bloomfield students. This program is currently scheduled to run throughout the remainder of the school year. It is imperative that families who qualify for free and reduced meals still complete the lunch application as this is a temporary program and is subject to change. Additionally, this information is used in district grant applications. Please contact Food Service Director, Todd Fowler at (585)657-6121 ext. 1151 for additional information.

Please complete one form for each child in the family for the week of June 14 through June 18. Please complete this form before 5:00pm June 10.

Breakfast menu options will include cereal or a breakfast item. Each Breakfast order will include fruit juice and milk.

Lunch menu options will include the choice of a ham sandwich, a turkey sandwich, a peanut butter and jelly sandwich or a Garden Salad. Please look at the menu options carefully as some days there will be a new item added. All lunches will include 1% milk, fruit and vegetable.

If you need assistance completing the form, please call the Main Office at (585)657-6121 ext. 1006. The Main Office is available Monday through Friday from 6:00am. to 2:30pm.

Families who are not eligible for free and reduced lunch will be charged accordingly.
Breakfast $1.75
Lunch $3.05
*Free and reduced lunch application forms can be found on the district website.

BREAKFAST AND LUNCH WILL BE AVAILABLE FOR PICKUP FROM 11:00 AM - 12:30 PM EVERYDAY AT THE ATHLETIC ENTRANCE AT THE MIDDLE/HIGH SCHOOL FOR ALL GRADE LEVELS. ALL MEALS ARE FOR CURBSIDE PICK UP ONLY.
Email *
Student First Name *
Student Last Name *
Which school does this student attend? *
Best phone number to reach you. *
Please select your choice for breakfast and lunch
Breakfast Item (breakfast)
Ham Sandwich (Lunch)
Cheeseburger Meatloaf (Lunch)
Peanut Butter & Jelly Sandwich (Lunch)
Garden Salad (Lunch)
Monday, June 14
Please select your choice for breakfast and lunch.
Breakfast Item (Breakfast)
Hot Dog (Lunch)
Turkey (Lunch)
Peanut Butter and Jelly Sandwich (Lunch)
Garden Salad (Lunch)
Tuesday, June 15
Please select your choice for breakfast and lunch.
Breakfast Item (Breakfast)
Ham Sandwich (Lunch)
Bacon Cheeseburger (Lunch)
Peanut Butter and Jelly Sandwich (Lunch)
Garden Salad (Lunch)
Wednesday, June 16
Please select your choice for breakfast and lunch.
Breakfast Item (Breakfast)
BBQ Rib (Lunch)
Turkey Sandwich (Lunch)
Peanut Butter and Jelly Sandwich (Lunch)
Garden Salad (Lunch)
Thursday, June 17
Please select your choice for breakfast and lunch.
Breakfast Item (Breakfast)
Ham Sandwich (Lunch)
Chicken Ranch Wrap (Lunch)
Peanut Butter and Jelly Sandwich (Lunch)
Garden Salad (Lunch)
Friday, June 18
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