Community Summer Lunch Program

Registration Required

Please complete the following sign-up for the Community Summer Lunch Program.
Lunches will be served July 6 - 30th Mon-Thurs at the Pit Stop from 11-1.  
Curbside pick up for Friday's lunch, and weekend food packs, will be at the Blackford County Fairgrounds 11-12.
Montpelier Friday pick up will be at  the First Church of the Nazarene, 440 North Standard Oil Blvd.

If you have trouble filling out this form, paper copies are available at;
Community and Family Services 1015 W Washington Street, Hartford City.


Sign in to Google to save your progress. Learn more
Email Address *
Parent/Guardian Name *
Parent/Guardian Phone Number *
How many youth are in your home? *
Children's Names *
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy