Special Nutrition Programs: Forms

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CACFP Forms Fiscal Year 2009 (Application & Income Eligibility)

Income Eligibility Forms

CAC 11 Child Eligibility Application (PDF, 58 KB)
CAC 11 Child Eligibility Application (SOLICITUD PARA PODER INTEGRAR EN EL PROGRAMA DE COMIDAS PARA NIÑOS) (PDF, 367 KB)
CAC 11A Adult Eligibility Application (PDF, 57 KB)
CAC 11A Adult Eligibility Application (SOLICITUD PARA PODER INTEGRAR EN EL PROGRAMA DE COMIDAS PARA ADULTOS) (PDF, 127 KB)
CAC 11B Children Enrolled in Family Day Care Homes (PDF, 110 KB)
CAC 11B Children Enrolled in Family Day Care Homes (NIÑOS INSCRITOS EN GUARDERÍAS EN CASAS PARTICULARES) (PDF, 73 KB)
CAC 11C Provider's Income and Provider's Own Children (PDF, 64 KB)
CAC 11C Provider's Income and Provider's Own Children (INGRESO DEL PROVEEDOR y de los HIJOS DEL PROVEEDOR) (PDF, 122 KB)

CACFP Forms Fiscal Year 2008 (Application & Income Eligibility)

Application Forms

Income Eligibility Forms

CAC 11 Child Eligibility Application (PDF, 69 KB)
CAC 11 Child Eligibility Application (SOLICITUD PARA PODER INTEGRAR EN EL PROGRAMA DE COMIDAS PARA NIÑOS) (PDF, 60 KB)
CAC 11A Adult Eligibility Application (PDF, 58 KB)
CAC 11A Adult Eligibility Application (SOLICITUD PARA PODER INTEGRAR EN EL PROGRAMA DE COMIDAS PARA ADULTOS) (PDF, 68 KB)
CAC 11B Children Enrolled in Family Day Care Homes (PDF, 66 KB)
CAC 11B Children Enrolled in Family Day Care Homes (NIÑOS INSCRITOS EN GUARDERÍAS EN CASAS PARTICULARES) (PDF, 72 KB)
CAC 11C Provider's Income and Provider's Own Children (PDF, 65 KB)
CAC 11C Provider's Income and Provider's Own Children (INGRESO DEL PROVEEDOR y de los HIJOS DEL PROVEEDOR) (PDF, 71 KB)

SFSP Forms Fiscal Year 2008 (Operations, Record-Keeping, Monitoring, Outreach, Regulations and FNS Instructions and Guidance)

Operation

SFSP Site Level Claim Reimbursement (PDF, 38 KB)
Sponsor Claim Checklist (PDF, 70 KB))
ADA Amendments Transmittal (PDF, 15 KB)
Site Addition-Deletion Transmittal (PDF, 15 KB)
Change in Meal Service Transmittal (PDF, 14 KB)
Ethnic and Racial Data (PDF, 10 KB)
Field Trip Approval (PDF, 16 KB)
Year End Worksheet (Excel, 20 KB)

Record-Keeping Forms

Bulk Food Delivery Transfer Slip (PDF, 14 KB)
Daily Meal Count Form (PDF, 31 KB)
Daily Meal Count Record by Name Ages 1-2 Years (PDF, 32 KB)
Daily Meal Count Record by Name Ages 3-5 Years (PDF, 32 KB)
Daily Meal Count Record by Name Ages 6-12 Years (PDF, 31 KB)
Daily Meal Count Record for Children (PDF, 17 KB)
Meal Count Worksheet for Camps (PDF, 21 KB)
Mileage Record (PDF, 11 KB)
Monthly Meal Count Summary (SFSP-13) (PDF, 9 KB)
Sponsor Site Agreement (PDF, 8 KB)
Sponsor Site Supervisor Agreement (PDF, 9 KB)
Time Record – Staff (PDF, 13 KB)
Unitized Food Delivery Transfer Receipts (PDF, 11 KB)
Weekly Meal Count Summary (SFSP-12)

Monitoring Forms

Sponsor Site Pre-Operational Visit Review (PDF, 27 KB)
Sponsor Site Visit Review Form - First Week(PDF, 12 KB)
Sponsor Monitor Site Visit Review Form - Four Week (PDF, 21 KB)

Outreach

Regulations and FNS Instructions and Guidance

7 CFR 225 Summer Food Service Program Regulations (link opens in new window)
FNS Civil Right Instructions 113-1
FNS Financial Management Instructions 796-4
SFSP Guidance (link opens in new window)
Nutrition Guidance (link opens in new window)
Crediting Food Guide

CACFP Forms Fiscal Year 2007 (Application, Claims, Record-Keeping, Review)

Application Forms

Claims Forms

Record-Keeping Forms

Review Forms

SFSP Forms Fiscal Year 2007 (Operation, Record-Keeping, Monitoring, Outreach, Regulations and FNS Instructions and Guidance)

Operation

Record-Keeping Forms

Monitoring Forms

Outreach

Regulations and FNS Instructions and Guidance

7 CFR 225 Summer Food Service Program Regulations (link opens in new window)
FNS Civil Right Instructions 113-1
FNS Financial Management Instructions 796-4
SFSP Guidance (link opens in new window)
Nutrition Guidance (link opens in new window)
Crediting Food Guide

File Viewers

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Excel Viewer 2003 for Windows
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