Meal Delivery Survey

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* 1. Parent/Guardian contact name completing this survey

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* 2. What is a good contact phone number for you?

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* 3. My preference for meal distribution for my children while we continue in remote learning is

Pick up at the school site

Have meals delivered to my child's bus stop and/or home

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* 4. If you selected meal delivery at home/bus stop please include your address

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* 5. Please list the children (student's) in your home for meal delivery

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* 6. Do you currently have access to internet for your children to complete assignments?

Yes

No

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* 7. If you do not have internet are your children completing instructional packets?

Yes

No

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* 8. Please provide the names/school of your children IF you need printed materials delivered to your home and/or picked up?

Child's name (school)

Child's name (school)

Child's name (school)

Child's name (school)

Child's name (school)