USC Meal Order for Pick-Up for December 7-11
Complete this form BY 8 AM FRIDAY, DECEMBER 4th, if you want meals delivered to a fire station for your children on these days: December 7-11

- COMPLETE A SEPARATE FORM FOR EACH CHILD. (Note: You do not need to order meals for students in the daycare program.)

- PICK UP LOCATIONS:Fire Stations in Bricelyn, Easton, Freeborn, Kiester, Walters, and Wells

- Meals will be available for pick-up between 11:00-11:30.

* USDA has extended the FREE meals wavier to continue for all children enrolled in our district throughout the 2020-21 school year. USC will provide free meals to all students in our district.
First Name of Person Completing this Form *
Last Name of Person Completing this Form *
Student's First Name (Reminder: Complete a separate form for each child.) *
Student's Last Name *
Grade Level of Student *
On which days do you need a meal for your student?
Mon., Dec. 7
Check if you want a meal for your student on this day.
Tues., Dec. 8
Check if you want a meal for your student on this day.
Wed., Dec. 9
Check if you want a meal for your student on this day.
Thurs., Dec. 10
Check if you want a meal for your student on this day.
Fri., Dec. 11
Check if you want a meal for your student on this day.
Meal pick-up is between 11:00-11:30 AM. From which FIRE STATION will you pick up your meals? *
Does your child have a documented doctor's order for a special diet or food allergy? *
If so, please list:
Submit
Never submit passwords through Google Forms.
This form was created inside of United South Central Public Schools. Report Abuse