Meal Pack Order Form January 4th-8th 2021
All children ages 2-18 residing in the Waupun Area School District are eligible to receive free breakfast and lunch meals through JUNE. Children who are learning virtually, being homeschooled, or are currently at home due to the COVID-19 illness, quarantine, or school closure may receive a weekly meal pack box. The meal pack will contain some items that need to be refrigerated. Unbox your meal pack and store items as directed in the pantry or refrigerator. Some meals will also contain microwave heating instructions.

Please complete this form to order MEAL PACKS of breakfast and lunch meals for the week of January 4th-8th. Only one form should be submitted for each HOUSEHOLD. Orders are due by 5 PM on Friday, January1st.

Pick up meals for the week on Monday morning at Waupun Junior/Senior High School* or Rock River Intermediate School from 7:30-10:00 One person should pick up all meal packs for the household.


*At Jr/Sr HS use door N2. Drive through the one-way semi-circle where the flagpole is located. Toward the end of the circle drive turn right onto the driveway leading up to the building. Call 920-324-5591 and press option 2 to let the Food Service Department know you are there. Your meal pack order will be brought out to you.
Email address *
First name of person completing this form: *
Last name of person completing this form: *
Phone number of person completing this form: *
Household address: *
Number of ALL people in the household (all children and adults) *
Number of children ages 2-18 in the household *
Meal packs will be picked up at: *
Number of children needing meal packs for the week of January 4th,2021 (use the "other" option to enter a quantity greater than 4): *
A carton of milk or milk substitute will be provided for each meal. Check the box below if you do NOT want milk included with your meals.
Do any children receiving meals require a milk substitute? *
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