Meal Service Sign-Up 2017-02-22T22:56:42+00:00

Meal Service Sign Up

This sign up form is per client. You must complete a new form for each client you are signing up. This form is for Private Pay clients ONLY. If you require financial assistance, you must call our office at 505-823-8082 between 9am – 2pm, Monday – Friday to inquire about grant availability.

Please fill out all information. A Client Services Coordinator will call to confirm your start date.









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Please Check this box to indicated acceptance of these terms and that you have recorded the address to mail checks to.