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Emergency Contact Information

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Additional Emergency Contact - optional

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APPLICATION/AGREEMENT STATEMENT

1. I would like to apply for Meals-on-Wheels. I understand that the cost will be $7.50 per day for one hot meal and one cold meal; 2. The meals will be delivered to my door on a daily basis - Monday through Friday, including holidays; 3. I will give at least 2 business days’ notice if I wish to cancel the Meals-on-Wheels program; 4. Except in the case of medical emergencies, if I need delivery stopped for one day, I will call the office at least 2 business days in advance.

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La Jolla Meals On Wheels Client Application

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