Viroqua Area Schools Meals Program
Viroqua Area School District is providing meals for families that would like to participate. Just like our Summer Food Service Program, ALL children 18 years and younger who live in our District are eligible for breakfast and lunch each day at no cost. There are no income-based qualifications needed to participate. This program is also available to private school and home-schooled children.

If you want to participate and receive meals, you will need to complete this form so we can begin preparing and organizing our meal program for you.

* Please do not complete this form more than one time for your family. If you have a change or have any questions, please contact us by phone or email.
bvold@viroquablackhawk.org or 608-637-1181
ethkri@viroquablackhawk.org or 608-637-1645

• Meals will be provided Monday - Friday.

• When you submit this form you will receive a message that says, "We've received your response. We will contact you by phone or email to confirm when delivery will begin."

Responses received by 3:00 pm will likely receive meals the following day. We will contact you to confirm when delivery will begin.

If you need assistance completing this form or have questions about this program, please call 637-1181 or 637-1645. You may also reach us at bvold@viroquablackhawk.org or ethkri@viroquablackhawk.org
Email address *
Do you want to participate and receive meals *
Required
Please enter your first and last name (as the responsible adult) *
Your answer
Please add the best phone number to contact you. *
Your answer
Please tell us how many children 18 years old or younger that you are requesting free breakfast and lunch for.
Your answer
List the names for children receiving meals.
Your answer
Are there any adults that would like to purchase meals for (breakfast and lunch) at the rate of $7.00 per day to be paid upon delivery each day?
If yes, how many adult meal packages at $7.00 per day are you requesting?
Your answer
Please list any allergy requirements that we need to be aware of.
Your answer
We plan to deliver meals approx. 10:00-12:00 each day along regular bus routes. Pick-up locations will be available from 11:30-12:00. We need to know for planning purposes where we can deliver your meals. Please choose the best answer.
Please tell us your address.
Your answer
If your child rides a regular bus route please tell us your the bus number (if you know it).
Your answer
If your child does not ride a regular bus route, you may select their city stop or a pick-up location below.
Thank you for your participation and completing this form. Please add any additional notes that you feel we may need to help you with our meals program. We hope that we can help you and your family stay healthy and safe during these difficult times. Sincerely, Dr. Kehl Arnson
Your answer
A copy of your responses will be emailed to the address you provided.
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