2022-2023 Pearson Student Lunch and Dismissal Plans

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Please fill out this form for EACH child in your family that attends Pearson. The information provided here will help the staff at Pearson prepare for the return of Face to Face instruction.

Student's Legal First Name *

Student's Legal Last Name *

Student's Nickname (name student goes by):

Student's Teacher *

Will your child be eating the school-served breakfast daily? *

Yes

My child's breakfast purchase will depend on the day.

Please specify your child's likely lunch: *

My child will bring a lunch from home

My child will buy a lunch from the cafeteria

My child's lunch choice (bring lunch or buy lunch) will depend on the day.

Please specify how your child will go home each day: *

If you answered daycare, please write in the name of the daycare center below:

Additional Comments

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