Free Meal Program Order Form
THIS FORM MUST BE COMPLETED WEEKLY AND MUST BE SUBMITTED BY 9AM THE FIRST DAY OF THE WEEK. Breakfast and Lunch will be given at the same time.

Meal Pick-Up locations and times are as follows:
Rolling Hills Elementary, 10:15 - 10:45 AM
Willow Vista ECA, 1:00 - 1:30 PM

The FIRST time you come to pick up meals we will need to see one of these documents for each child requesting a meal:
1. Official letter/email/electronic school application from school listing children enrolled.
2. Individual Report Card.
3. Attendance record from parent portal of the school website, printed or electronic, that includes child’s
names.
4. Birth certificates for children not in school.
5. Student ID.
Total number of children you are requesting meals for? *
This week my child (ren) will need meals on which days?
Please select the campus you will be picking up your child(ren)'s meals from today. *
Child 1 Needing Meal (Please include first name and last name) *
Child 2 Needing Meal (Please include first name and last name)
Child 3 Needing Meal (Please include first name and last name)
Child 4 Needing Meal (Please include first name and last name)
Child 5 Needing Meal (Please include first name and last name)
Please select the campus/campuses each of the above listed child(ren) attend.
Willow Vista ECA
Rolling Hills Elementary
River Road Middle School
River Road High School
Child not enrolled in RRISD
Campus Child 1 Attends
Campus Child 2 Attends
Campus Child 3 Attends
Campus Child 4 Attends
Campus Child 5 Attends
Clear selection
If you have additional children that will need a meal, please enter information below. Reserve a separate line for each child, listing first and last name, as well as campus.
Each day my child(ren) will be needing... *
Parent/Guardian Name and Phone Number *
Submit
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