Meal request for distance learning (for pick up)

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Please fill out meal request for ONE DAY AT A TIME. Please fill out by 8:00am the day you will be picking up.

Please fill out one form for each student. Meals can be picked up in office at the location you choose. Meals will consist of a ready to eat cold lunch/breakfast.

PLEASE BRING YOUR OWN BAG FOR TRANSPORTING MEALS

Date meal(s) is needed

YYYY

Student Name

Please indicate any allergies:

Grade

Breakfast

Yes

Clear selection

Lunch

Yes

Clear selection

Pick up Site

Humphrey Elementary (pick up available 11am-12pm)

Winsted Elementary (pick up available 11am-12pm)

High School (pick up available 11am-1pm)

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Submit

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