What is the best contact number to reach you? (please enter dashes between the numbers. Example: 859-555-5555)
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Please list the name(s) of your child/children. If more than one, separate with a comma (example: Suzie Jones, Fred Jones, Sybil Smith) *
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My child/children attend: (check all that apply) *
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Boyle County Schools will be setting up drive-thru locations that offer breakfast and lunch. These will be held at Junction City Elementary, Perryville Elementary and Boyle County High School. Do you anticipate using these locations for some of your meals? *
Do you need to request home delivery of meals because you are unable to travel to a site? (ie: Boyle County High School, Southland Christian Church, Junction City Elementary School, Perryville Elementary School and/or Perryville Baptist Church) *
Do you need additional food besides breakfast/lunch that is already being served? *
If you are in need of home delivery, please provide your physical address (house number, street name, city). *
Your answer
Please specify the number of children 18 and under whom you are requesting home delivery for: *
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Please list any other concerns you may have. (Optional)
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Parent/Guardian Initials (to serve as electronic consent): *
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