Student Feeding Survey

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Please fill out this form so that we can plan food purchase, distribution and staffing. Pick up location for student food is in the car line at the back of the elementary campus. Time for distribution is: 10:00am-12:00pm. Breakfast/Lunch Kit will be distributed to any child 18 years and younger that is PRESENT in the car. School feeding begins Tuesday, March 24th.

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* Indicates required question

Do you plan on participating in our student feeding program? *

Yes

No

If yes, how many children 18 years and younger will be participating from your home? (children must be in the car when you pick up the food)

1

2

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10

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