Lincoln Consolidated School District Summer Break Meal Order Form

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By completing this form, you are preordering breakfast and lunch for your child 18 years or younger during the summer. Each food box will be packed with 5 student breakfast meals and 5 student lunch meals. With the exception of June 27th, 10 days will be packed.A family can request for all children 18 years or younger living in the household. These meals are available at no cost. Parent or guardian must be present to pick up meals.

Beginning June 20 th 'Meal Pick-Up' EVERY Thursday (no pick up July 4th week) from 12:00 p.m. - 2:00 p.m. at LMS at the bus pickup line between Middle School and playground. If this time does not work for your schedule please contact nutrition service at 479-824-7310 ext 103 to make pick-up arrangements.

Email *

Do any of your children have an allergy, if so what is it? We will accommodate as well as possible. *

Are there any dates you will not be able to pick up? Dates are June 20th, June 27th, July 11th, July 18th, July 25th and August 1st. Please let us know so we can plan better. Thank you. *

How many children live in your household that are 18 years or younger? This will determine the number of meals included in your box. *

Other:

Child/Children's Name and Grade: List each students name and grade *

Preference on milk *

milk, you will recieve half chocolate and half white carton milk

no milk

Name of Legal Guardian or Parent Requesting the meals *

Phone Number *

Preferred method of contact *

phone call

text message

My school age children attend Lincoln Consolidated School District? *

Yes

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