Restaurant Meals Program Information Form

RESTAURANT OWNER INFORMATION FORM

Complete the form below and submit via email OR click here for the form in PDF format.

Restaurant Name:

Owner Name as shown on business license permit:

   Last Name:       First Name:

  Owner(s) Last Name:

  Owner(s) First Name:

Business Address:

City Business Zip Code

Business Phone E Mail

Mailing Address

Mailing City Mailing Zip Code

Contact Person

Last Name First Name

Phone Number Cell Number

Fax Number

The information above will be used to prepare the Memorandum of Understanding (MOU) that will be mailed to you along with the Food and Nutrition Service (FNS) application for meal services.

Portable Document Format (PDF) allows anyone to view the file using Adobe’s free Acrobat Reader software.
To download the free reader, click here