White Settlement ISD Child Nutrition Programs

Account Restriction Form-Elementary

If you choose to restrict your child on what they may purchase, a message will appear on the students lunch account.

Please indicate below and return this form to your child’s school cafeteria or email to khuey@wsisd.net or cnicholas@wsisd.net. You may also fax to 817-367-1223

Please check the following choices:

_________ Meal Only (Breakfast or Lunch meal only, No: extras, snacks, water, etc….)

_________No Breakfast

_________No snacks (ex. Chips, cookie, HS-Gatorade,HS & MS 12oz drinks)  

_________Snacks on Friday only (or specify day or days)

_________No extras (ex. Entrees, extra fruit or vegetable, bottle water)

_________Cash only for snacks (must have cash in hand)


School:   ____________________________________

Name of student _____________________________ Account number______________

Parent/Guardian _____________________________

Download the Account Restrictions Form here, and then return it to your Child's School Cafeteria


WSISD Child Nutrition Office | 700 Odie Street | White Settlement, TX 76108 | (817) 367-1310 | Fax (817) 367-1223

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