Campus eSchool Meal Pick-up Registration
This survey is for students enrolled in the Polk County School District Campus eSchool program only. Please complete this form for each student for whom you plan to pick up meals. Families may choose one school for meal pick-up for all of their registered students. Once you have selected your school, your student(s) will be placed on a roster for weekly meal pick-up at that location, and will no longer be able to pick up at their school of enrollment. Students will provide their name and ID number to be verified upon pick up. If students are not present to pick up meals, valid child identification will be required.

Valid forms of child identification include:

School identification card
Page printed from parent portal showing student’s name and ID number
Record from the school showing student name and ID number (report card, schedule, etc)
Child’s passport
Government-issued child identification card
Other legal document identifying the child

This form only needs to be completed one time. Once submitted, your student will be registered for meal pick-up for the duration of our Campus eSchool meal service.
Parent or Guardian (Last Name, First Name) *
Parent or Guardian Phone Number *
Please include your area code and use the following format: 555-555-5555.
Parent or Guardian Email
Student Last Name *
Student First Name *
Student ID# *
Student ID# should begin with 5300.
Student's School of Enrollment *
Please select the school where your student is enrolled in the Campus eSchool program.
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