Take Home Meal Form
By submitting this form, I am requesting that breakfast and lunch be sent
home for my student on the days that my student is attending virtually.
I am aware that my student’s account will be charged according to
his/her meal status (paid, reduced, or free).  Meals will be available 1 week after the form is submitted.
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Student Name *
School Student Attends *
Rotation Day *
Parent Name *
Date *
MM
/
DD
/
YYYY
Submit
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