Cafeteria Refund/Transfer/Donate Request Form

Student withdrawals and Graduating Senior refunds will be issued by check. Graduating senior balances will be transferred to sibling accounts unless a refund request is submitted. Alternatively, balances can be donated to our Charitable Fund for the benefit of our economically disadvantaged students. Please note, refunds of $5.00 or below must be picked up from the Business Office at 800 Pine Street, Emmaus. You can request a refund or make a donation by completing the form below.

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(ex: Graduating Senior, Student Withdrawn from District, Staff Resigned, Donation to Economically Disadvantaged Students, etc.)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