Meal Pick Up Registration
Select the site you plan on picking up your meals at. *
Name of Parent/Guardian who will be picking up meals. *
Name of alternate Parent/Guardian who will be picking up meals. *
Student 1 Name and Grade
Student 2 Name and Grade
Student 3 Name and Grade
Meal Selection
Breakfast
Lunch
Both Breakfast and Lunch
Student 1
Student 2
Student 3
Clear selection
Meals per week
3 days a week
5 days a week
Student 1
Student 2
Student 3
Clear selection
Additional students, grades and meal choices
Are there any dietary restrictions for any of the listed students and if so what are they?
Application for Education Benefits - free/reduced meals ***The district still needs applications done even when providing free meals through the summer foods program. These applications drive our school funding.*** *
Yes
No
Have you completed an Application for Education Benefits?
Do you need an Application for Education Benefits?
Do you understand the Summer Foods program will end 12/31/20 or sooner with little notice and meals will go back to free/reduced/paid?
Row 4
What phone number can we reach you at if we have questions concerning meals and delivery? *
Submit
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