Applications & Forms

How to Apply - Complete instructions for:
Adult Day Care Centers - Licensed
After School Programs
Child Care Centers - Licensed or License-Exempt
Homeless Shelters
Family Child Care Homes - Licensed

CACFP Applications & Forms

pdf

CACFP 1   Application and Management Plan for Participation in the Child and Adult Care Food Program (CACFP)

pdf      

CACFP 2   Application/Center Information for the Child and Adult Care Food Program (CACFP)

pdf

CACFP 205   Income Eligibility Form for Child Care Centers

pdf       doc

CACFP 208   Statement of Affiliation, for not-for-profit organizations

pdf      

CACFP 209   Application Budget – Child Care or Adult Day Care Center, Outside School Hours Center, Emergency Shelter or At-Rist After School Snack Program

pdf       doc

CACFP 210   Menus, required with all CACFP applications

pdf       xls

CACFP 213   Daily Attendance Record

pdf       doc

CACFP 214   Documentation of Non-profit Food Service (Updated - Summary of Salary Expenses)

pdf       doc

CACFP 215   Individual Infant Meal Record 0 Through 3 Months

pdf       doc

CACFP 216   Individual Infant Meal Record 4 Through 7 Months

pdf       doc

CACFP 217   Individual Infant Meal Record 8 Through 11 Months

pdf       doc

CACFP 218   Menu - USDA Requirements (5 days letter size)

pdf       doc

CACFP 218   3-Meal Menu Template

pdf       doc

CACFP 218 A   Menu - USDA Requirements - 7 Days (letter size)

pdf       doc

CACFP 218 AA   Menu - USDA Requirements -7 Days (legal size)

pdf       doc

CACFP 218 B   Menu - USDA Requirements for Shelters (letter size)

pdf       doc

CACFP 218 BB   Menu - USDA Requirements for Shelters (legal size)

pdf       doc

CACFP 220   Enrollment Roster

pdf       doc

CACFP 221   Time In/Time Out Record

pdf       doc

CACFP 222   Training Documentation

pdf       doc

CACFP 223   Production Records, Breakfast and Lunch/Supper

pdf       doc

CACFP 224   Monthly Attendance Time In/Time Out Record

pdf       doc

CACFP 225   Meal Count (Monday thru Friday - letter size)

pdf       doc

CACFP 225A   Meal Count (Sunday thru Saturday - legal size)

pdf       doc

CACFP 225B  Shelter Meal Count (Sunday thru Saturday - letter size)

pdf       doc

CACFP 226   Beneficiary Data Report

pdf       doc

CACFP 227   Medical Food Substitution Record

pdf       doc

CACFP 229 Enrollment Form for Child Care Centers

pdf

CACFP 230 CAP Fillable Form

pdf

SCCR-CACFP [Joint] Child Care Enrollment Form (MO 580-2994)

pdf       doc

CACFP 404   Sponsored Centers Site Visit Report

pdf

CACFP 501   Income Eligibility Form for Adult Care Centers

pdf

Vendor Input/ACH-EFT Application – SAM II (required for new applicants and to change direct deposits)

pdf

CACFP Network User Access Request Form

pdf      doc

Carlton Carrot’s Menu Template

pdf

Contracting for Food Service - Instructions and Prototypes

pdf      doc

Daily Menu Planning and Production Record for At-Risk Programs

pdf

Food Chart - Adult

pdf

Food Chart - At-Risk After School

pdf

Food Chart - Children

pdf

Food Chart - Infants

pdf

Four Components in Menu Planning

pdf

Infant and Toddler Feeding and Care Plan for both Centers and Homes

pdf       doc

Meal Count Record (Tally) for At-Risk Programs

pdf       doc

Monthly Donated Food Log for Shelters

pdf

Non-Discrimination Policy Statement (Pricing Centers Only)

pdf       xls

Shelter Meal Count (Sunday thru Saturday - letter size)

pdf       doc

Shelter Resident Roster by Month

pdf       doc

Shelter Resident Roster by Period

pdf       doc

Snack and Supper Menus for at-risk programs