Jackson Local Schools Backpack Program Application 2022-23

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This form will be used as an application for any student in Jackson Local Schools who is in need of a food backpack for the weekends. The goal of this program is to send home a variety of easy, ready to eat meals and snacks for your child over the weekend. Please fill out 1 form for each child. Note- if bags are not picked up without contacting for 2 weeks, you will have reapply.

Student Name *

Student Parent Name *

Contact Email *

Contact Phone Number *

What School would you like your child's backpack to be picked up from? *

Jackson High School

Jackson Middle School

Amherst Elementary

Lake Cable Elementary

Sauder Elementary

Strausser Elementary

Grade of Child? *

Any Allergies? If so what? *

I give my child permission to receive a backpack as part of the Jackson Schools backpack program *

Yes

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