2016 EXTENDED SCHOOL YEAR AND SUMMER SERVICES INFORMATION WORKSHEET SPECIAL NEEDS MEALS (DUE DATE MAY 13, 2016) – Complete this page for any student with a disability that requires specialized food preparation. ESY/SUMMER ESY/SUMMER STUDENT STUDENT GRADE SPECIALIZED FOOD SCHOOL LOC # SCHOOL NAME NAME ID (2016-2017) PREPARATION (specify) Indicate if ESY dates of attendance are other than 07/05/16 08/01/16 –
2016 EXTENDED SCHOOL YEAR AND SUMMER SERVICES INFORMATION WORKSHEET SPECIAL NEEDS MEALS (DUE DATE – MAY 13, 2016) Complete this page for any student with a disability that requires specialized food preparation. ESY/SUMMER SCHOOL LOC # ESY/SUMMER SCHOOL NAME STUDENT NAME STUDENT ID GRADE (2016-2017) SPECIALIZED FOOD PREPARATION (specify) Indicate if ESY dates of attendance are other than 07/05/16 – 08/01/16
ESY_info_worksheet16.docx