Mission Statement

To provide all students at Pelham City Schools a healthy balanced nutritious meals and to increase knowledge of the importance our eating healthy. While building and maintaining relationships with parents, teachers and our community partners to sustain our nutrition programs.

Director of School Nutrition
Robin Stokes
rstokes@pelham-city.k12.ga.us
Phone: (229) 294-8715  |   Fax: (229) 294-2760

 Language and Disability Assistance for the School Nutrition Program
Vince Frosteg
vfrosteg@pelham-city.k12.ga.us
Phone: (229) 294-8715  |   Fax: (229) 294-2760

Requesting Special Diet Procedure

Attention Parents:
Attached is a Food Allergy Notification Form/Request for Accommodations for Special
Diets. This form must be used when submitting documentation for School Meal
Adjustments due to medical reasons and MUST be signed by a licensed medical professional.
.
Part 1: To be completed by Parent/Guardian
Part 2: Food Allergy section. To be completed by a licensed medical professional.

This notice only has to be submitted one time during your child's school enrollment. This
notice will remain on file and meal accommodations will remain in effect unless we receive a statement from the licensed medical professional adjusting guidance outlined on this form.

Again, you will only be required to submit this form ONE time during your child's school
enrollment in Pelham City Schools. Adjustments to meal components must be supported by
a medical statement if future changes are required. Otherwise, dietary adjustments will
remain in effect until the student leaves the Pelham City School System.

If your child has a food allergy and meal adjustments are required, please take this form to
your licensed medical professional for completion and signature.
Failure to provide this form can jeopardize your child's nutritional safety while at school. It
is our desire to protect and provide for your child during meal time as instructed by a licensed medical professional. Please assist us by submitting required documentation as outlined.

Sincerely,
Pelham City School Nutrition Department
*Return form to your child's school nurse

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Pelham Elementary School
Pelham City Middle School
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