1/6 Meal Sign-up for Virtual Students

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By filling this out, you are agreeing to pick up meal(s) Wednesday morning, January 6th, from 9:00 a.m. - 10:00 a.m. at door 2 of Seymour High School or the side entrance of Black Creek Elementary/Middle School. Meals are now free due to the USDA waiver that was approved for Seymour on September 4th.

Email *

Name of Student *

Which building is your child assigned to attend? *

Rock Ledge Primary

Rock Ledge Intermediate

Seymour Middle School

Seymour High School

Black Creek Elementary/Middle School

Pick up location *

Door 2 of Seymour High School

Side door of Black Creek Elementary/Middle School

Number of breakfasts you would like to order for Wednesday, January 6th. *

2 breakfasts

1 breakfast

No breakfasts

Number of lunches you would like to order for Wednesday, January 6th. *

2 lunches

1 lunch

No lunches

A copy of your responses will be emailed to the address you provided.

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