Lunch Balance Refund Request
Please complete this form to request a lunch balance refund.
Email
*
example@example.com
Student Name
*
First Name
Last Name
Student Lunch Number (if known)
School Student Last Attended
*
Tipton Elementary School
Tipton Middle School
Tipton High School
How would you like to receive your refund?
*
Check
Transfer to Another Student Account
Transfer to the Charitable Lunch Donations Account
Other
If you wish to transfer to another student, please provide their name, grade, and lunch number (if known).
If you wish to receive a check, please provide the parent/guardian full name and address.
Additional Comments or Questions
Submit
Should be Empty: