Meal Delivery Program Form
Delton Kellogg has been offering meal bags to all students for pick at the high school every Wednesday evening since September. We have been able to distribute over 14,000 meals to students and children ages 0-18 so far.

We have received a grant to be able to bring the food directly to families! We are very excited about this. We have found that due to transportation issues, timing, etc... pick up does not always work for families.

This is for all students not receiving or being offered breakfast and lunch in a school setting. This includes children ages 0-18 not enrolled in school or those up to 26 years of age with a disability in our community.

This program will begin Wednesday, January 13, 2020. Deliveries will be made in the morning - times will be set depending on the numbers of stops on the routes.

What do you need to do to receive the meals and help the program be successful?

1. Complete the form! This will tell us your child's name(s) and address. Address is very important so we can create the most effective routes for the drivers. Please list each student separately. This will help with an accurate count.

2. Please indicate on the form if you are able to pick up meals if the central location is brought closer to you. The locations currently are: Prairieville, Delton Methodist Church, Dowling and Gun Lake (Circle Inn) Locations may be added based on location and need.

3. If a central location does not work for you - please indicate that also.

4. Share the program with others who may be interested in receiving meals and meet the criteria.
Total number of students in your household to receive meal bags: *
Student Name - please list each student separately, Student Grade and Age if not enrolled in school (ex: Johnny Smith: 6th grade) *
Student Status: (choose all that apply)
Address: *
Contact Phone #: *
Contact Email Address: *
Would you be able to pick up meals from a central location?
Clear selection
Please select a location pick that work best for you.
Clear selection
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