MOUNT HOREB AREA SCHOOL DISTRICT
Phone 608.437.2400 | Fax 608.437.5597 | Website mhasd.k12.wi.us
District Office | 1304 E. Lincoln Street, Mount Horeb, WI 53572
We have many families in our community who may be struggling with food insecurity. Mount Horeb Area School District (MHASD) has a program to provide non-perishable food to families over the weekends and school breaks. You do not need to qualify for free or reduced lunches to be eligible.
If you are interested in this program, please read this and fill out the questionnaire below. This will help us better meet your needs.
How will the program work?
Each week, a backpack with food or other items will be available for your child to take home for the weekend. The backpack is being provided for your convenience and needs to be returned each week. This will help your child be able to get the food home easily.
What kind of food will the backpack include?
The backpack will have shelf stable food and other non-perishables for your family. As funds are available, we will continue to provide perishables from Kwik Trip.
Contact Information:
Name ______Email______Phone______
How many people do you have in your household?
Children ______Adults______
(under 18) (18 and over)
Do you have anyone with food allergies in your household? (please explain)
Are there specific foods you need more than others?______
Are there foods that you do not need/like?______
Do you have other non-food needs?______
Do you own a microwave? Yes______No______
Do you own a can opener? Yes______No______
What child would you like the backpack to go home with?
Name______Grade______
Teacher______
How would you like us to send the food home? (choose one)
Pick up in the school office (indicate which school) ______
Food Pantry______Youth Center______
Please take this form to the District Office, 1304 East Lincoln or email it to Michelle Denk, . Your food deliveries will begin the week that you return your form.
Thank you,
Michelle Denk, Food Service Director 608-437-7065
Dr. Steve Salerno, Superintendent | | 608.437.7010
Mr. Scott DeYoung, Assistant Superintendent Business and Finance | | 608.437.7030
Mr. Brian Johnson, Director of Student Services | | 608.437.7016
Mrs. Sarah Straka, Director of Instruction | | 608.437.7013
Mrs. Cynthia Swart, Human Resources Coordinator | | 608.437.7034