PLT3 Food for "A day" Attendance
Please fill out this form by December 31.
* Required
Name of parent or guardian
*
Your answer
Phone number
*
Your answer
Terms
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.
*
Yes
No.
Next
Page 1 of 13
Never submit passwords through Google Forms.
This form was created inside of Prophetstown-Lyndon-Tampico CUSD#3.
Report Abuse
Forms
