Food Allergies & Special Diets 2019-20
If your child would like to have a school lunch, but has a food allergy and/or special diet, please fill in the following form, and schedule a time to speak about these requests with the Cafeteria Manager, Mr. Sandijs Volinskis, at 28647892 or at
. Students who are vegetarian, vegan or have religious customs, do not need to set up a separate consultation. Thank you!
Student's full name (first, last)
Parent's name (first, last)
Grade for SY 2019-20
My child has allergies to
No food allergies
If your child has other food allergies not listed above, please list below.
My child requires a special diet
No dairy products
No pork, due to religious customs
No beef, due to religious customs
If your child requires a special diet not listed above, please describe....
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