Remote Meal Ordering Form

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SEBRSD will be providing FREE Breakfasts and Lunches to all students!
Meals can be pickup at all schools in the district on Monday-Thursday
PICK UP MEALS AT KITCHEN BACK DOORS!

Knox Trail Middle School 10-1

East Brookfield Elementary School 10-12

Remote meals will be picked up in bulk and ordered on the Google Form Link
Monday for Monday- Wednesday
Wednesday Thursday and Friday

***Please fill out the form below***

Family name for pick-up *

Days of the week ordering for *

Monday

Tuesday

Wednesday

Thursday

Friday

Required

Number of students receiving meals each day (number of students in household) *

Child

Childern

REMOTE Pick-up location *

ONLY--Knox Trail Middle School (10am-12pm) MONDAY (Meals for M-W)

ONLY--Knox Trail Middle School (10am-12pm) WEDNESDAY (Meals for T-F)

BOTH Knox Trail Middle School (10am-12pm) MONDAY & WEDNESDAY (Meals for M-F)

ONLY--Wire Village Elementary School (11am-1pm) MONDAY (Meals for M-W)

ONLY--Wire Village Elementary School (11am-1pm) WEDNESDAY (Meals for T-F)

BOTH Wire Village Elementary School (11am-1pm) MONDAY & WEDNESDAY (Meals for M-F)

ONLY--East Brookfield Elementary School (12:15pm-1:15pm) MONDAY (Meals for M-W)

ONLY--East Brookfield Elementary School (12:15pm-1:15pm) WEDNESDAY (Meals for T-F)

BOTH East Brookfield Elementary School (12:15pm-1:15pm) MONDAY & WEDNESDAY (Meals for M-F)

ONLY--David Prouty High School (10am-12pm) MONDAY (Meals for M-W)

ONLY--David Prouty High School (10am-12pm) WEDNESDAY (Meals for T-F)

BOTH David Prouty High School (10am-12pm) MONDAY & WEDNESDAY (Meals for M-F)

HYBRID- Meals brought home on Thursday for Friday *

YES- Wire Village

YES- East Brookfield Elementary

YES- Knox Trail Middle

YES- David Prouty High School

NONE

Dietary restrictions with doctors note provided to nurse

Vegetarian or Gluten Free meal required?

Yes- V

Yes- GF

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