• At-Home Meals Consent Form

    St. Francis Xavier
  • This form must be filled out and submitted by 3pm Friday, October 2 in order to receive meals on Tuesday, October 6. If you have already signed up for the quarter, you do not need to fill this form out again. Meals will be packaged and ready for pick up at your school site every Tuesday between 12:30pm and 1:30pm. For questions, please contact the Child Nutrition Program at (225)-387-6421.

    • Meals will be distributed at no cost.
    • Only one breakfast meal and one lunch meal per enrolled student per day may be requested (up to 5 breakfast meals and 5 lunch meals per week). 
    • Students receiving meals must be enrolled in virtual learning or under temporary quarantine.
  • I will be picking up breakfast meals and lunch meals per child each week.

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  • Parent/guardian signature implies consent for meal pick-up; appropriate meal charged to student’s account as determined by student’s full price, reduced price or free meal status on file; and meal received is solely for the student listed above.

    This institution is an equal opportunity provider.

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