Summer Meal Program - July 2021
This form is for requesting meals for the month of July. Meals will be provided Monday-Friday. Pickup is weekly on Tuesdays from 4:30-5:30pm at the loading doors by the kitchen at the North Mahaska School.

This program is available for Anyone 18 and Under.  You do NOT have to be in the district, but you DO have to submit this form.  Please submit this form for each child you would like to receive a meal.  To avoid waste, meals for July are only provided for those who have requested through this form by the deadline of 5:00pm on June 21.
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Email *
Parent Name *
Email *
Contact Phone Number *
Child's First Name *
Child's Last Name *
Does your child have a food allergy? *
If yes, please explain the allergy. *
I understand that the meals will be available for pickup every Tuesday between 4:30 and 5:30pm at the loading doors by the kitchen. *
A copy of your responses will be emailed to the address you provided.
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