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Site Meal Count
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* Indicates required question
Name
*
Your answer
Phone #
*
Your answer
Date
*
MM
/
DD
/
YYYY
Day of the week
*
Monday
Tuesday
Wednesday
Thursday
Friday
Distribution Location (Where are you serving meals?)
*
Amoosement Park 12-1 Lunch M-F
First Baptist Church 12-1 Lunch M-F
Goose Bay Elementary 12-1 Lunch M-F
Nunley Park 12-1 Lunch M-F
Palmer Museum/Vistor Center 12-1 Lunch M-F
Wasilla Library 12-1 Lunch M-F
Hagen Park 12-1 Lunch M-F
Other:
Components of meal (ex. Bread, Cheese, Turkey, Carrots)
Your answer
How many meals did you pass out?
*
Choose
1
2
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65
Meals not consumed on site
Your answer
Comments, Requests, Suggestions
Your answer
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