Extended School Closure Food Request Form
The Alton R-IV School District is making preparations for free grab-and-go food pick-up for families who need this service. The program is for children ages 18 or under. We will provide breakfast and lunch to be picked up at one time. Details on the date, time, and location will be announced soon.

**Please fill out this form one time for EACH student who needs food service during school closure.**

Students MUST be in the vehicle with you when you pick up the food.

Student First and Last Name: *
Your answer
Student Age: *
Your answer
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