Sick Meal Request for Resident Students or Camper

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Eligibility: Any resident student or camper who is unable to come to a dining hall because of illness, whether under physician’s orders or voluntary self-isolation.

Cost: 1 Meal Swipe per Meal Selected.

Phone Number (including area code) *

Dining Hall *

Broderick Dining Commons (Pickup Times: M-F: 7a-9p; S-S: 9:30a-9p)

Rogers Riverside Cafe (Pickup Times: M-F: 11a-4p)

Select Your Meal Option (Please note: some offerings may not be available in which case we will inform you) *

(Breakfast Option) Banana, Oatmeal and Orange Juice + Milk and Dry Cereal

Entrée, Starch and Vegetable of the Day, Banana, 2 Water Bottles, & 2 Starry's

(2) 16oz Cups Chicken Noodle Soup, Crackers, Applesauce Cup, Banana, 2 Water Bottles, & 2 Starry's

Quarantine meal—Student needs to be on the list sent from housing

Dietary Restrictions

Today's Date *

YYYY

UIN or Camp *

Full Name *

Resident Hall (If applicable; Off-Campus Students just indicate "Commuter") *

First & Last Name of Pickup Person *

Pick Up Date *

YYYY

Pick Up Time
- Broderick Dining Commons Hours:
M-F: 7a-9p; S-S: 9:30a-9p

- Rogers Riverside Cafe Hours:

M-F: 11a-4p

Time

Terms and Conditions *

By signing this form, I agree that Monarch Dining will provide the designated pick-up person below with the sick meal as outlined above and charge my meal plan One (1) Meal Swipe.

I am submitting this Sick Meal Request at least 2 hours prior to pick up

I have inputted a Pick Up Time within Broderick Dining Commons' or Rogers Riverside Cafe's hours of operation

Required

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