ࡱ>    !"#$%&'()*+,-./0123456789:;<=>?@ABCDRoot EntryZ O2DwECONTENTS CompObjVSPELLINGx____________________ am signing up my child(ren): _________________________________________________________________ for the Little Harvard Food Program. I understand that the $10.00 is due on Monday of each week, though I may pay up front for as many weeks as I would like. I also, understand that by signing this form, I am committed to the Food Program for the current year of 2011/2012 and may choose to terminate my agreement with a week s notice, if I find it does not meet the needs of myself or my child(ren). There will be an additional fee of $2.00 per day for every day your meal plan is left unpaid. In the event you mistakenly forget to pay your meal plan on Monday, or forget to send in a lunch for your child(ren), by law, we are required to offer your child a meal and payment will be expected to be brought current at the end of the day. _____________________________________ __________________________ Signature Date I _________________________________________ am declining to participate in the Little Harvard Food Program for my child(ren):_______________________________________ I will provide a nutritious breakfast and/or lunch on the days my child is in attendance at Little Harvard. I understand that if I am unable to provide a lunch, one will be offered to my child and that payment for that lunch will be expected at the end of the school day. The fee for lunch will be $3.00 per meal. ______________________________________ __________________________ Signature Date I _________________________________ understand as a parent who receives assistance thru New York Dept. of Social Services for childcare, I am not responsible for the $2.00 per day fee for lunch. If my assistance stops/ends then I understand that I will CHNKWKS TEXTTEXT$FDPPFDPP FDPPFDPP"FDPCFDPC$FDPCFDPC&STSHSTSH(STSHSTSH(8SYIDSYIDV(SGP SGP j(INK INK n(BTEPPLC r( BTECPLC ( FONTFONT(RSTRSPLC ):PRNTWNPR>)YFRAMFRAMւTITLTITL^6DOP DOP ay pay up front for as mLittle Harvard 63 Lawrence Avenue New Windsor, New York 12553 Phone 845-565-6112 Sept. 2012 Dear Parents/Guardians: As explained in the attached letter, we will be asking each family that would like to continue being part of the Food Program at Little Harvard to contribute $10.00 per week. This fee will be due on Monday. This check or cash should be given separate of your tuition. If you choose to participate in this program and your child does not come on a full time basis, your rate will be pro-rated based on the number of days your child is in attendance. For Example: 2 days per week - $4.00 for the food program 3 days per week - $6.00 for the food program 4 days per week - $8.00 for the food program 5 days per week - $10.00 for the food program If you have a child who is enrolled in the Before/After School Program and is not consistently in attendance for lunch, your fee will be assessed at the end of the month and will be noted on your payment notice for the following month. Because we will be purchasing food in advance, this amount will be due regardless of absences due to illness, vacations, or food preferences. If you choose to not participate in the food Program, you will be responsible for providing your child with a balanced and nutritious lunch. If you would like assistance or ideas for lunch choices that will meet the Food Pyramid standards, please don t hesitate to ask. Remember, we are still a peanut free school and have many children who have serious allergies, please read all labels carefully when making menu choices for lunch. In addition, snacks and breakfast will still be offered to those not signing up for the Food Program. Sincerely, Antonia Uszenski Director Food Program Agreement I ___________________have to pay the fee for my child/children lunch. ______________________________________ ____________________________ Signature Date the Food Program. Sincerely, Antonia Uszenski Director Food Program Agreement I ___________________:P^  JNPRhjlf@"T|~.pTVb,12"'( ) @S  !"1""11  !"1""111 "$,12"'( ) @S (2"'( X- 0Z *n  f F\Tfr|`X(XXX(X. "$ 08. "PS$ 08,  "PS$ 080  "PS$ 08( "PS$ 08* "$ 08* "PS$ 08, "0$  08 ` "$|T|T("$ 08. "PS"$ 08( "PS$ 08* "PS$ 08 xTSH$xTSH  ""  "tt$ "`$$&>ONT,Times New RomanImpact " " "XXFwp LCanon MX890 series Printer ߁d BJDM VT$m,`Oj,`OjVT$m,v`Oj,v,v`OjXX'dVT$mVT$m@  VT$m   Canon MX890 series Printer ߁ odLetter6w,winspoolCanon MX890 series PrinterCNBJNP_888717B0F809F"d5 "R"]"i "` "`""A."@"d5 "|"]"i "` "`"."Food Program Agreement.wps"`"` ( "PS$ 08* "PS$ 08 Z O2Quill96 Story Group Class9qy`y` y``y``,y`/` y` ` y` `9 y`<