Food at School Information Form

This form must be submitted to the Thunder Bay District Health Unit before starting a program
and again at the beginning of each school year.

Send completed form to: Thunder Bay District Health Unit

Environmental Health Department
999 Balmoral Street Thunder Bay ON P7B 6E7
Phone: (807) 625-5926 Fax: (807) 625-4822

School:________________________________________________________________
Address:_______________________________________________________________
Phone Number:__________________________________________________________
Principal:_______________________________________________________________

“Food at School“ Contact Peron:_____________________________________________

Please check all events planned for your school:

School Nutrition Programs (meal and snack)

Are outside agencies involved in delivering these programs? Please list:
______________________________________________________________________

Special Lunches (pizza, subs, pitas, pasta, etc.)

Do outside businesses provide food for some or all of these lunches? Please list:
______________________________________________________________________

Barbecues

Further details will be requested at a later time.

PLEASE RETURN THIS FORM BY OCTOBER 15TH EACH SCHOOL YEAR

Revised: October 2015