Breakfast/Lunch Request Form
Are you interested in receiving a free lunch/breakfast? ( all children age 1 year to 18 years old qualify for a free meal)
Names of children you want meals for:
Meal Delivery: Will you be doing curb-side pickup in front of the Grade School, or require rural delivery within the school district boundaries? Child must be present to receive meal, however, child may receive meal without adult present.
If requesting delivery, what is your delivery address:
Please check which days you are requesting meal(s).
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This form was created inside of Valley Falls USD 338.