2020-2021 RCS Friday/Weekend Meal Delivery Request
Please complete the form if you are unable to pickup your child’s meals at identified sites being offered through our Roane County Schools Friday/Weekend Meal Program. Please only complete one entry per household. Please note that completing the form does not guarantee your child’s meals will be delivered; responses will be reviewed, and you will be contacted.

Designated pickup sites from 10AM-12PM:
Dyllis Springs Elementary School
Harriman High School
Midtown Elementary School
Midway Middle School
Roane County High School
Rockwood High School
Parent/Guardian First Name *
Parent/Guardian Last Name *
Parent/Guardian Address *
Parent/Guardian Phone Number *
Can the above phone number receive text messages? *
Number of children (birth-18) in the household *
At which school(s) do your school age children attend? Check all that apply. *
Never submit passwords through Google Forms.
This form was created inside of Roane County Schools. Report Abuse