Refund Request Form for School Nutrition and Curricular Material Rental Fees


  • Be sure to complete the address section correctly, as your refund will be mailed to you.
  • You may choose to donate your credit to our Angel Fund or transfer the remaining balance to another student by marking the form as directed.
  • Use this form if you would like to request a refund from your School Nutrition Account. A refund request will be processed after verifying the balance on the student’s account. Please allow a few weeks to process the form and complete the check for mailing. Contact with questions regarding School Nutrition.

Meal Payments, Charge & Refund Procedures: (View Full Version)

Forms of Payment: All cafeteria purchases are to be prepaid before meal service begins. GCS Cafeterias utilize a pre-pay computerized system; we also accept credit card deposits at Goshen High School for student convenience. All students and district employees may set up a district account. Money can be deposited into an account for the purchase of breakfast, lunch, milk, and ala carte foods. Cash/check collection during a lunch or breakfast period is not allowed as it slows the serving line. Therefore, all cash/check payments must be submitted prior to breakfast or lunch. At an elementary, payments are collected each morning in the classroom. At GHS and GJHS, payments may be given to the bookkeeper or a nutrition staff member at the cafeteria Point of Sale (POS). There are two options available for pre-payment:

  • 1) Major credit/debit card online meal payment program on the district website under Food Services.
  • 2) Cash/Check: Please place in a sealed envelope with the child’s name, classroom, and grade clearly written on the outside of the envelope. Make checks payable to GCS Nutrition Services or (School Name) Cafeteria. If paying for more than one child, the check must specify how much is to be deposited into each child’s account.  If a check is returned due to non-sufficient funds, GCS will assess a $20 fee per check. After two NSF checks are received per family per school year, checks will no longer be accepted from that family.

Meal Charging & Refunds

  • GCS wants to ensure that every student has access to meals daily. GCS is not allowed, per USDA regulations, to incur bad debt from unpaid meal charges. GCS is not required by federal or state law to provide meals to any student (except those eligible for free meals) who does not have payment either on account or in hand for a meal. If families need to apply for meal assistance, they can do so at any time throughout the school year using the online meal application program on the district website under Food Services.
  • Meal Charging: Students may charge (go negative). If an account remains negative, the account may be turned over to a collection agency. A student who has charged for a meal may not charge or purchase “a la carte” item(s), including extra main entrees. Funds may be transferred between student accounts in the same household up until one week after the close of the school year. Negative balances will be considered delinquent debt and forwarded to the business department on or before June 30th of each school year for further processing which may include formal debt collection proceedings. Any active or inactive account may be sent to a collection agency by GCS.
  • The food service manager or other school personnel will coordinate communications with the parent(s)/guardian(s) to resolve the matter of unpaid charges.
  • Adults are not allowed to charge but are able to set up pre-pay accounts using the online meal payment program on the district website under Food Services.
  • If a student repeatedly comes to school with no lunch and no money, food service employees must report this to the building principal as this may be a sign of abuse or neglect and the proper authorities should be contacted.
  • If food services staff suspects that a student may be abusing this policy the parent(s)/guardian(s) may be contacted. If the student continues to abuse this policy, the privilege of charging meals will be refused.
  • Contact the GCS Director of School Nutrition at (574) 533-8631 ext. 12020 if a student has special circumstances (dietary, financial etc.) that should be taken into consideration.
  • Refunds:
    1. Students who graduate or withdraw from the corporation and have $10.01 or more left in their lunch/meal food service account will be notified by mail by food services at the end of the school year and given the option to transfer the funds to another student or to receive a refund. The email account or ParentSquare for the household may be used for this purpose. If no request is received within 30 calendar days after the last day of school, the student’s lunch/meal account will close, and no further refund attempts will be made.
    1. Students who graduate or withdraw from the corporation and have less than $10.00 will not receive a direct notification by mail but may request a refund. If no request is received within five (5) business days after the last day of school, the student’s lunch/meal account will close, and no further refund attempts will be made. Remaining unclaimed balances will be transferred to the student in need (Angel) fund for the purpose of meals only. Parent/Guardian can request a refund using the online form found at


In accordance with federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, the USDA, its Agencies, offices, and employees, and institutions participating in or administering USDA programs are prohibited from discriminating based on race, color, national origin, sex, disability, age, or reprisal or retaliation for prior civil rights activity in any program or activity conducted or funded by USDA.  

Persons with disabilities who require alternative means of communication for program information (e.g., Braille, large print, audiotape, American Sign Language), should contact the agency (state or local) where they applied for benefits. Individuals who are deaf, hard of hearing or have speech disabilities may contact USDA through the Federal Relay Service at (800) 877-8339.  Additionally, program information may be made available in languages other than English.

To file a program complaint of discrimination, complete the USDA Program Discrimination Complaint Form, (AD-3027) found online at: How to File a Complaint, and at any USDA office, or write a letter addressed to USDA and provide in the letter all of the information requested in the form. To request a copy of the complaint form, call (866) 632-9992. Submit your completed form or letter to USDA by: 

    1. mail: U.S. Department of Agriculture
      Office of the Assistant Secretary for Civil Rights
      1400 Independence Avenue, SW
      Washington, D.C. 20250-9410; 
    2. fax: (202) 690-7442; or 
    3. email: