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Cafeteria Account Refund Request

Please complete this form to request a refund of your child's cafeteria account. Please allow 30 days for refunds to be completed. If you have any questions, contact the Child Nutrition Office at 832-668-7049.

Refund Request

Student Name

Answer Required

Student ID #

Answer Required

School

Answer Required

Amount Requested

Answer Required

Do you want us to give your child the refund?

Answer Required

Yes

If yes, Student Name and Grade

Answer Required

By checking this box and giving your name you are approving that the money requested be given directly to the child indicated.

Answer Required

I agree

Parent Name

Answer Required

If the refund is over $25.00, it must be processed through the Child Nutrition Department. Refunds less than $100 may be picked up at the Child Nutrition office.

Check the box below indicating how you would like the refund processed.

Answer Required

Check mailed to the address below.

Cash picked up from the Child Nutrition Office, 309 W P Street, Deer Park, TX 77536. Parent will be notified via email when the refund is ready for pick-up.

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Parent Name

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Phone Number

Number Required

Email address

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Address

Street Address

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City

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Zip/Postal

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By checking this box I agree that the information above is correct.

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Date

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Confirmation Email

Email Required