Summer Meal Order Form
Please complete this form to order packaged breakfast and lunch meals for the week of August 3rd. Pick up days are Monday, Wednesday, and Friday. Only one form should be submitted for each HOUSEHOLD. In order to qualify for meals, you must live within the Waupun Area School District boundaries and have at least one child attending school. All children in the household who are age 18 and under may receive meals. A new form will be made available each week for families to order meals for the next week.

Free breakfast and lunch meals will be available for pick up at Rock River Intermediate from 9:00-11:00 AM and at SAGES Charter School from 9:00-10:00 AM on Monday, Wednesday, and Friday. One person should pick up all meals for the household. Meals need to be eaten at home as our buildings are closed. Some meals may contain microwave heating instructions.

If you need meals but are unable to pick them up please call Amber McLinn for assistance at 920-948-3707.
Email address *
First name of person completing this form: *
Last name of person completing this form: *
Phone number of person completing this form: *
Household address: *
Number of people in the household (all children and adults) *
Name of a (one) child attending school: *
Name of the school that child attends: *
Location meals will be picked up from: *
Number of children needing meals Monday, August 3: *
Number of children needing meals Tuesday, August 4: *
Number of children needing meals Wednesday, August 5: *
A number of children needing meals Thursday, August 6: *
Number of children needing meals Friday, August 7: *
Each meal comes with a carton of milk or milk substitute. Check the box below only if you do NOT want milk included with your meals.
Do any children receiving meals require a milk substitute? *
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