Claremont Unified School District                Ramadan To-Go Meals Request Form 
  •  CUSD will be offering “grab and go meals” to Claremont Unified students fasting during Ramadan to promote nutrition security, health equity, and to ensure children have access to the nutrition they need.
  • Both breakfast and lunch will be provided. 
  • The initiative will be effective March 3 through March 28, 2025. 
  • Student(s) must be enrolled at the school site of meal pickup location and attended school the day they are picking meals up. 
  • Please submit one request per student. 
  • Meals will need to be picked up daily by students or parent/guardian at the end of the school day at their school office. 
  • If you no longer wish to receive grab and go meals, please let your school cafeteria know to prevent food waste. 
  • Meals will be vegetarian, cold and will require some warming. Heating instructions will be provided with the meal but can also be found by clicking here. 
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Select your school site: *
Student's First Name  *
Student's Last Name *
Student's ID Number *
Please list any food allergies here or special meal accommodations here. 

Please note, we kindly request to have a Medical Statement on file. Please contact the Nutrition Services department at (909) 398-0358 if you have questions. 
Weeks student will be participating (check all that apply):  *
Required
USDA Nondiscrimination Statement 

In accordance with federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, this institution is prohibited from discriminating on the basis of race, color, national origin, sex (including gender identity and sexual orientation), disability, age, or reprisal or retaliation for prior civil rights activity.

Program information may be made available in languages other than English. Persons with disabilities who require alternative means of communication to obtain program information (e.g., Braille, large print, audiotape, American Sign Language), should contact the responsible state or local agency that administers the program or USDA’s TARGET Center at (202) 720-2600 (voice and TTY) or contact USDA through the Federal Relay Service at (800) 877-8339.

To file a program discrimination complaint, a Complainant should complete a Form AD-3027, USDA Program Discrimination Complaint Form which can be obtained online at: https://www.usda.gov/sites/default/files/documents/ad-3027.pdf, from any USDA office, by calling (866) 632-9992, or by writing a letter addressed to USDA. The letter must contain the complainant’s name, address, telephone number, and a written description of the alleged discriminatory action in sufficient detail to inform the Assistant Secretary for Civil Rights (ASCR) about the nature and date of an alleged civil rights violation. The completed AD-3027 form or letter must be submitted to USDA by:

mail:
U.S. Department of Agriculture
Office of the Assistant Secretary for Civil Rights
1400 Independence Avenue, SW
Washington, D.C. 20250-9410; or

fax:
(833) 256-1665 or (202) 690-7442; or

email:
Program.Intake@usda.gov

This institution is an equal opportunity provider.

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