Dear Parent/Guardian:

The Valley Stream Central High School District currently has received a waiver for the State’s
requirement to conduct a breakfast program for students. Each year, the District must survey
parents to gauge their interest and to determine if they would participate in a breakfast program
should one be offered. We do this by surveying parents as to if their children would utilize such a
program. Please note this waiver will apply to the 2019-20 school year.

The cost of a cold breakfast (cereal or a roll, milk and juice) would be approximately $1.00.
Children on the free and reduced lunch schedule would be entitled to free and reduced priced
breakfast.

Please indicate on the survey form below whether your child would participate in the breakfast
program. Filling in the form is not a commitment; it is merely your best estimate at this time.

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* 1. If the breakfast program were offered, would your child/children participate an average of three days per week?

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* 2. Parent/Guardian Name

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* 3. Child's Name

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* 4. Address

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* 5. School

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* 6. Grade September 2018

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* 7. Grade September 2019

0 of 7 answered
 

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