Meal Request Form

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Meal Request Form

Please fill out this form (one time) if you are requesting district-provided meals from the dates March 24 through April 3rd. The current day's lunch and the next day's breakfast will be available daily Monday-Friday. These are available to any person 18 years and under and are at no charge to the participants. Meals are being provided through a waiver granted to the Department of Health and Senior Services from the United States Department of Agriculture. The waiver allows the Cameron School the option to serve meals during unanticipated school closures related to a public health emergency in a non-congregate setting. *Disclaimer these meals are not regulated by dietary restrictions. i.e. gluten-free, nut-free

Name of parent/guardian requesting meals *

Contact number of parent/guardian *

Physical address of the student where meals are to be delivered. (If the daytime location is a daycare or babysitter, please provide this address instead of the student's home address.) *

Please provide the total number of meals requested. (Must be 18 years and under to qualify) *

Does your child currently participate and receive meals through the Backpack Buddies Program? *

Yes

If receiving meals through the Backpack Buddies Program, please list the number of students in your household that are currently receiving meals.

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