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Summer 2021 Food Program
Please complete this form if you would like your child(ren) to receive free meals over the summer. Starting July 13th and ending August 17th, all meals will be available for pickup every Tuesday at Franklin Academy from 11:00 AM to 12:30 PM. You will be picking up the whole week's meals at once. Please bring a cooler with you to transport perishable items.
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Your last name:
*
Your answer
Your first name:
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Your answer
Your phone number:
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Your answer
Your email address:
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Your answer
Home (911) address, include the number, street/route, town:
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For example: 42 Husky Lane, Malone
Your answer
Number of children requiring food service:
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1
2
3
4
5
6
Child #1 - Last Name, First Name:
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Your answer
Will child #1 be attending a summer program at one of our schools?
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Yes
No
Child #2 - Last Name, First Name:
Your answer
Will child #2 be attending a summer program at one of our schools?
Yes
No
Clear selection
Child #3 - Last Name, First Name:
Your answer
Will child #3 be attending a summer program at one of our schools?
Yes
No
Clear selection
Child #4 - Last Name, First Name:
Your answer
Will child #4 be attending a summer program at one of our schools?
Yes
No
Clear selection
Child #5 - Last Name, First Name:
Your answer
Will child #5 be attending a summer program at one of our schools?
Yes
No
Clear selection
Child #6 - Last Name, First Name:
Your answer
Will child #6 be attending a summer program at one of our schools?
Yes
No
Clear selection
If any of the above children have food allergies, please list all allergies here:
Your answer
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