Summer Feeding Sign Up
Please fill out this form to request participation in the Houston County Summer Feeding Program. We will contact you to confirm your program's eligibility. 
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Name of Group/Program/Organization *
Name of Contact Person *
Contact Person's Phone Number *
Contact Person's Email Address *
Address where meals will be served. Please include Street, City, and Zip Code. *
Program Start Date *
MM
/
DD
/
YYYY
Program End Date *
MM
/
DD
/
YYYY
What days will you be serving meals? *
Required
What meals will you be serving? *
Required
What time will you serve breakfast?
Time
:
How many meals do you need for breakfast?
What time will you serve lunch?
Time
:
How many meals do you need for lunch?
Please select your preferred pick up site. *
Are there any other details we need to know? (ie: program only operates M, W, F.)
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