Cafeteria Refund/Transfer/Donate Request Form

Student withdrawals and Graduating Senior refunds of $5.00 or more will be mailed within 30 days of withdrawal/graduation date–completing the form is not necessary. Graduating senior balances will be transferred to sibling accounts unless a Refund request is submitted.

Staff cafeteria account refunds of $5.00 or more will be sent upon request.

If you have any questions regarding the form, please contact Lisa Boland in the Food Service Office at (610) 966-8309 or lboland@eastpennsd.org

Requests for Refunds or Transfer of Funds from a Cafeteria Account can be made by completing the form below. Please allow at least 30 days from date of request for refund.

**IMPORTANT: Please disable Auto-Replenish in SchoolCafé.com before requesting a refund.

Cafeteria Refund/Transfer/Donate Request Form

Date(Required)

Amount (if other than full balance)(Required)

Student or Staff Name(Required)

First Last

School(Required)

Student ID #(Required)

Transfer to ID #(Required)

Reason for Request(Required)

(ex: Graduating Senior, Student Withdrawn from District, Staff Resigned, Donation to Economically Disadvantaged Students, etc.)

Email Address(Required)

Check payable to:(Required)

Address(Required)

Street Address City State / Province / Region ZIP / Postal Code