North Smithfield School Department Meal Account Refund/transfer Of Funds Request Form
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1North Smithfield School Department
MEAL ACCOUNT REFUND/TRANSFER OF FUNDS REQUEST
Student’s Name: ____________________________________________________________
Grade: _______
Student’s 6-Digit ID Number: _______________
School: __________________________________________
Parent’s Name: ________________________________________________________________________________
Phone Number: Home: ___________________ Wk: _____________________ Cell: _____________________
Mailing Address: _______________________________________________________________________________
City, State, Zip Code: ___________________________________________________________________________
Reason for Transfer/Refund:
___Graduated
___Transfer Outside District
___Other, Explain______________________________________________________________________
___ Transfer funds to:
Sibling’s Name: __________________________________________
Grade: _______
Sibling’s ID# _____________
Sibling’s School: ____________________________
Please note that a student’s meal account money is automatically carried over to the next school year EXCEPT after completion of
the 12th grade. If your child will not be attending a school within the North Smithfield School District his/her money can be
transferred to a sibling in your family or refunded after completion of this form. Please allow 30 days for your request to be
processed. Please contact the Aramark School Nutrition Services (401) 597-6128 if you have any questions or need clarification.
______________________________________________________
_________________
Signature of Parent/Guardian
Date
Parents:
Please fill out this form completely. Sign it and mail to:
Aramark School Nutrition Services
412 Greenville Road
North Smithfield, RI 02896
Office Use Only:
Aramark: Verify Amount of Transfer or Refund: $_____________
Verified by: ___________________________
600100000.99998.998.98.9800.41611.9800.00
NSSD Business Department
Account Number:
Requisition # ______________ Date: _____________
____ Refund
Amount of Refund $____________ Date of Refund: ___________ Ck #: _____ Initials: _______
Aramark : Entered in NutriKids
____ Transfer
Amount of Transfer: $______________
Date of Transfer _________________ Initials: _______
____ Refund
Amount of Refund $__________ Ck# ____ Date of Refund: ______________
Initials: _______
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