March 2020 Lunch Program

Please answer the following questions to sign up for our home lunch program.

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* 1. Please list student(s) name(s) who attend our school.

1.

2.

3.

4.

5.

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* 2. Do you have younger children that are not in school and may need a lunch? If so, how many?

1

2

3

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* 3. How many total lunches do you need?

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* 4. What is your Address? House Number and Street

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* 5. What is your Zip Code?

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* 6. Will you be able to pick up lunches at a location near your home?

Yes

No

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* 7. Would you prefer to pick up the lunches at one of our school sites? If yes, please select the site you will pick up lunches.

Mt. Orab Middle School

Hamersville Elementary and Middle School