Summer Food Service
FREE TO ALL CHILDREN 18 YEARS OF AGE OR YOUNGER
3 BREAKFAST MEALS & 3 LUNCH MEALS = 6 TOTAL MEALS WILL BE PROVIDED WHEN YOU FILL OUT THIS FORM!

* MEAL PICKUP OPTION:
Meals available for pick up from 11:30 a.m. - 12:30 p.m.
- High School
- Sulphur Rock
- West

* PICK UP DAYS:
Tuesday & Thursday
3 breakfast meals + 3 lunch meals = 6 total meals will be provided when you come each day!

* START DATE & END DATE:
June 7th - July 29th (Every Tuesday and Thursday)

* FOR ASSISTANCE:
Please call our Food Service Department @ 870-698-0134 X 1201 ask for Sandy Williams.
Email *
Parent Name: (First and Last) *
Phone #: (870) 123-4567 *
Total # of students needing food? *
Food allergies? We accommodate for the big 8 USDA recognized allergies, Fin fish, Shell fish, Wheat, Tree Nuts, Peanuts, Eggs, Milk and Soy. Please let us know if you have one of these. If you have multiple children please tell us how many of each allergen *
Next
Never submit passwords through Google Forms.
This form was created inside of Batesville Public Schools. Report Abuse