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Nutrition Services - Meal Account Refund/Transfer/Donation Request Form

Required

All balances at the close of the school year will remain in the child(ren)'s account and be accessible to the student at the beginning of the following school year. For graduating seniors or students transferring out of the district, remaining funds may be transferred to a sibling, refunded, or donated to a household struggling to pay for school meals.
PARENT/LEGAL GUARDIAN
Please note that only the listed parent or guardian on the student’s meal account will be granted a refund or have the ability to do a transfer or donation.
Namerequired
First Name
Last Name
STUDENT WITH FUNDS
Student Namerequired
First Name
Last Name
Type of Requestrequired
STUDENT TO TRANSFER FUNDS TO
Transfer To Student Namerequired
First Name
Last Name
PARENT/LEGAL GUARDIAN
To whom refund will be mailed (please allow 10 business days):
Namerequired
First Name
Last Name
PARENT/LEGAL GUARDIAN SIGNATURE
I understand that by typing my name in the box below, I am agreeing to the use of electronic signatures and I certify that the information entered on this form is accurate and correct to the best of my ability.