Free Summer Meals Interest Survey
Chaplin Elementary School / Regional School District 11
1. Would your family be interested in receiving free summer meals for breakfast and lunch?
Yes
No
2. How many children aged 0-18 are in your family?
1
2
3
4 or more
3. Which time frame for meal pickup would work best for your family?
8am - 10am
10am -12pm
12pm -2pm
Family Name
Which town do you reside in?
Submit
Should be Empty: