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FREE SMOOTHIE FORM
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HOME
HOW IT WORKS
WHY IT MATTERS
VOLUNTEER
DONATE
STUDENT MENU
FREE SMOOTHIE FORM
CONTACT
Welcome, Students!
Do you live in an area that has limited access to healthy foods?
Use this form to request a
FREE
smoothie from Smoothies 4 Students.
Please also enter an adult/guardian's contact information so we can verify for safety purposes.
*
Indicates required field
Student Name
*
First
Last
Student ID #
*
Current School (Must Be Enrolled)
*
Adult/Guardian Phone
*
Adult/Guardian Email
*
Delivery Address
*
Line 1
Line 2
City
State
Zip Code
Country
Smoothie Flavor
*
No Preference
MBA (Mixed Berry Assortment): Strawberry, Blueberry, Raspberry, Blackberry, Banana
The Freshman: Strawberry, Banana
College Greens: Spinach, Kale, Pineapple, Banana, Ginger
Tropic-Alma Mater: Strawberry, Mango, Pineapple, Papaya
Major-9: Spinach, Kale, Pineapple, Banana, Papaya, Mango, Strawberry, Protein, Superfood Blend
The Recess: Peanut Butter, Banana, Cacao Powder
Please note: All smoothies are made with partial serving of plant-based protein and sweetened with honey.
Choice of Base
*
Almond Milk
Whole Milk
Please list any allergies or dietary restrictions
*
Is there anything else you think we should know?
*
Do you need any additional help with this form?
*
No, thank you!
Yes, please contact my guardian.
Submit
Please note: Feed The Future & Smoothies 4 Students are independently owned, operated and are not affiliated with MDCPS.