BJAMS FOOD PROGRAM Credit & Charging Authorization Form 2011-2012

BJAMS FOOD PROGRAM – Credit & Charging Authorization Form 2016-2017

To establish charging privileges, this authorization form must be completed and returned by the start of school. If this form is not submitted, charging privileges will not be granted. Additionally, if your family account has a balance from the 2015-2016 school year, your child(ren) will not be granted charging privileges until the overdue balance is paid in full. A positive balance must be maintained for each child for charging privileges to be maintained. Please understand that our policies for charging are strictly monitored.

By completing the following, you authorize charging privileges for your child(ren):

Child’s Name: ______Last: ______Grade: ______First Last Lunch: Y N Breakfast: Y N Snacks: Y N Circle Yes or No

Child’s Name: ______Last: ______Grade: ______First Last Lunch: Y N Breakfast: Y N Snacks: Y N Circle Yes or No Child’s Name: ______Last: ______Grade: ______First Last Lunch: Y N Breakfast: Y N Snacks: Y N Circle Yes or No

Please provide your email address so food Balance Statements may be sent to you weekly on Thursdays. You can access your statement and pay online at www.renweb.com. If you do not have email capacity, please indicate.

______Email address

ZERO BALANCE FRIDAY!!!

ZERO BALANCE FRIDAY means that your lunch & snack accounts must have a positive or zero balance on Fridays. Failure to do so means charging privileges will be suspended until the account is at a positive or zero balance. This means that your child will need to bring cash, snack or a lunch with him/her for lunch and snack until the balance is positive or zero on the account.

Please print and sign your name below:

______Print

______Signature of Parent or Guardian Date

Revised 6/2016