PLT3 Food for "A day" Attendance
Please fill out this form by December 31.
Name of parent or guardian
On holiday days, there will be no food provided.
If I request breakfast/lunch, due to an extension of the lunch waiver it will be provided free until the end of the 20-21 school year.
This waiver extends to anyone in the household who is 18 years old or younger.
Delivery is NOT an option for in-town students.
This form needs to be filled out by December 31.
I understand the terms listed above.
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This form was created inside of Prophetstown-Lyndon-Tampico CUSD#3.