*
Required
Parent's First Name
*
required
Parent's Last Name
*
required
School*
Grafflin
Roaring Brook
Westorchard
If the breakfast program were offered, would your child(ren) participate an average of 3 days per week?*
Yes
No
Child's Name (K-4 in 2024-25 ONLY)
*
required
Child's Grade in 2024-25*
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
2nd Child's Name (K-4 in 2024-25 ONLY)
2nd Child's Grade in 2024-25
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
3rd Child's Name (K-4 in 2024-25 ONLY)
3rd Child's Grade in 2024-25
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
4th Child's Name (K-4 in 2024-25 ONLY)
4th Child's Grade in 2024-25
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade