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Survey of Student Meal Needs During Closure
This is a survey for the need for student meals during the school closing and the COVID 19
pandemic. Please fill out this survey, if you have a need.
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* Indicates required question
Parent Name (Last, First)
*
Your answer
Date
*
MM
/
DD
/
YYYY
Phone Number
*
Your answer
Email Address
Your answer
Names of school-age children in household
*
Your answer
Are you able to pick up meals from the school
*
Yes
No
What other concerns with the program
Your answer
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