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2020-2021 Curbside Pick-Up Request Form
Please fill out the following form to ensure your child will receive their curbside breakfast/lunch.
Form must be filled out 24 hrs prior to the pickup!
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* Indicates required question
Student Name:
*
Your answer
Are enrolled in the High School Diploma Program? (21 - 26 Years Old)
*
Yes
No
Parent/Guardian's Phone Number:
*
Your answer
Parent Name who will be picking up meals: (ID will be required.)
*
Your answer
Select meals:
*
Breakfast
Lunch
Required
Select days:
*
Monday
Tuesday
Wednesday
Thursday
Friday
Required
Location:
*
Curbside at 3600 Memorial Bld. in Port Arthur (PreK - 2nd) between 10:30am - 11:30am
Curbside at 327 Thomas Blvd. in Port Arthur (3rd - 12th) between 11:00am - 12:00pm
Curbside at 1408 W. Park Ave. in Orange between 11:00am - 12:00pm
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