Food Service - Pick Up Request for 100% Remote Students
Please complete this form to allow the District to have an accurate number of meals prepared to allow for a seamless pick up for children in your household moving forward during the 2020-21 school year.  Food will be available for pickup, for students, at the 209 Complex (outside the HS), HBE and Middle School on Wednesdays from 12:00pm - 2:00pm.  Pickup will provide meals for the entire week (5 days). Any child ages 2-18, is eligible for meals.    

Meal Distribution Model:
- Wednesday pickup: Lunch (5 meals); Breakfast (5 meals)

Sign in to Google to save your progress. Learn more
Email *
I am selecting Pick Up at the following location: *
Next
Clear form
Never submit passwords through Google Forms.
This form was created inside of Port Jervis City School District. Report Abuse