School Name (required)

Application Completed by (required)

Email (required)

Address (required)

City (required)

Province (required)

Postal Code (required)

School Phone Number (required)

Principal (required)

Principal Contact Phone (required)

Nutrition Contact Name (required)

Nutrition Contact Phone (required)

School Population (required)

Please indicate the program/programs planned for your school and the number of students per week you anticipate will participate

Breakfast (required)

Snack (required)

Lunch (required)

Other questions or information

If accepted, gift cards and a gift card tracking sheet will be made available to your school. Additional cards will be issued only when the gift card tracking sheet and receipts for purchases are received. Gift cards are to be used to purchase nutritious food for your nutrition program.