School Snack Box Request
Enter your family details, allergies, and a pickup phone number.
How many Adults / Kids are in your household?
*
Please list any allergies in your household
Your first name:
*
Phone number for pickup arrangements
*
Please enter a valid phone number.
Format: (000) 000-0000.
I confirm that we live in the Dutton/ West Elgin Area
*
Yes
No
Submit Request
Should be Empty: