School Meal Count Report Form
Use this form to report daily school meal participation counts. Please complete all sections accurately.
Date of Report
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
School Name
*
Grade or Class
*
Meal Type
*
Please Select
Breakfast
Lunch
Dinner
Snack
Number of Students Participating
*
Number of Staff Participating
*
Total Meals Served
*
Meals Not Served (if any)
Person Submitting Report (Full Name)
*
First Name
Last Name
Additional Comments or Notes
Submit Report
Should be Empty: