2020-2021 Carter County School Nutrition Meal Pick-Up and Delivery Request Form  
As of September 1, 2020, Carter County School Nutrition Department is able to provide meals under the USDA SSO Program.  This means that we can provide breakfast and lunch to children under the age of 18 years old at no cost regardless of income until June 30, 2021.  USDA has provided our district the flexibility to serve children that are not enrolled in our school system.  We will offer drive-thru meal services at all of our schools from 11:00-12:00, Monday-Thursday each week.  Children will receive breakfast and lunch at that time.  On Fridays, we will offer drive-thru meal pick-ups at five school locations (Cloudland Elementary, Hampton Elementary, Happy Valley Elementary, Hunter Elementary, and Little Milligan Elementary).  Meal deliveries will only be available on Fridays until school resumes to five days a week. Delivery addresses must be on a Carter County School System bus route.   Please complete this form if you would like to receive meal delivery to your home or you will be picking up meals at the listed schools on Fridays.  
Sign in to Google to save your progress. Learn more
Parent/Guardian Name: *
Parent/Guardian Phone Number: *
Do you need school meals delivered to your home?  Only enrolled Carter County School students are eligible to receive school meals. *
Full Address that meals would be delivered:   (Example:  123 John Smith Drive, City, State, Zip Code)  Buses will not be able to deliver meals out of school district. *
How many children under 18 years old need meals delivered to this address? If more than 5, please call the Carter County School Nutrition Department at 423-547-2917 after you submit the form.
Clear selection
Please list student's full name.
Student's 4-digit cafeteria keypad number. This number is used when students come through the cafeteria serving line.  If you do not know the keypad number, please list 0000.
What grade is the student enrolled in during the 2020-21 school year.
Clear selection
Which school is your student enrolled in for the 2020-21 school year?
Clear selection
Next
Clear form
Never submit passwords through Google Forms.
This form was created inside of Carter County School District. Report Abuse
Google Forms