Virtual Student Meal Pick-Up Request Form 23-24 School Year
This Nutrition Services form is used to confirm pick-up for your student's weekly Breakfast and Lunch Grab 'N Go meals. Grab N' go boxes will be available every Wednesday from 2:00pm - 3:00pm at EOC -  Educational Options Center. Student will receive 5 breakfast and 5 lunches for the school week.
If you have questions regarding this form or meal service please call Nutrition Services at 951.352.6740.
 
**One form allows for 3 students. If you have more than 3 students, please submit another response.**
 
*The MEDICAL STATEMENT TO REQUEST SPECIAL MEALS AND/OR ACCOMMODATIONS* can be found at  bit.ly/nsdietsform

Este formulario de Servcios de nutrición se usa para confirmar que recogerán el desayuno y almuerzo Grab’N Go de su hijo.  Las cajas Grab ‘N Go estarán disponibles cada Miércoles de 2:00pm - 3:00pm  en EOC.  5 desayunos y 5 almurzos. Si tienen alguna pregunta acerca de este formulario o el servicio de comida, llamen al 951.352.6740.

**Un formulario permite tres alumnos.  Si tienen más de tres alumnos, entreguen otro formulario.**

***La  DECLARACIÓN MÉDICA PARA SOLICITAR COMIDAS ESPECIALES O ADAPTACIONES* se puede encontrar en la pagina web bit.ly/nsdietsform

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Email *
Parent/Guardian First Name and Last Name *
Parent/Guardian Phone Number *
Student ID Number (Student #1) *
Student ID Number (Student #2, if applicable)
Student ID Number (Student #3, if applicable)
Virtual School Pick-up Location
EOC - 6401 Lincoln Avenue,  Riverside CA 92506
 *
May  - Meal Pick Up Dates  *
Choose all dates meals will be picked up.
Required
My Student Has Food Restrictions *
If yes, explain below. Please note that a Special Diet Form is required.
I acknowledge the need to fill out this form on a weekly basis before each Wednesday's meal service or alternatively, select ALL available Wednesdays  for the entire month. It is understood that there is no charge for any meals provided to my student(s). Additionally, I confirm that I am exclusively collecting meals for students enrolled in the Riverside Virtual School at Riverside Unified School District."
 *
Required
A copy of your responses will be emailed to the address you provided.
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