Applications & Forms
How to Apply
CLICK HERE for Complete Application Instructions for:
- Adult Day Care Centers - Licensed
- At-Risk, After School Programs
- Child Care Centers - Licensed or License-Exempt
- Emergency & Homeless Shelters
- Family Child Care Homes - Licensed
Menus for New Meal Pattern (October 2017)
Note: All Word Documents are Fillable
| doc | USDA Requirements (5 day) | |
| doc | USDA Requirements (7 day) | |
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3 Meal Menu Template (5 day) |
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| doc | 5 Meal Menu Template (5 day) | |
| doc | 5 Meal Menu Template (7 day) | |
| doc | At-Risk Snack & Supper Menu Template (5 day) | |
| doc | At-Risk Snack & Supper Menu Template (7 day) | |
| doc | Individual Infant Meal Record, Birth to 5 Months (5 Day) | |
| doc | Individual Infant Meal Record, Birth to 5 Months (7 Day) | |
| doc | Individual Infant Meal Record, 6 to 11 Months (5 Day) | |
| doc | Individual Infant Meal Record, 6 to 11 Months (7 Day) |
Food Charts for New Meal Pattern
| doc | Infants | |
| doc | Breakfast | |
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Lunch and Supper |
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| doc | Snack | |
| doc | Adult | |
| doc | At-Risk, Afterschool |
CACFP Applications & Forms
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CACFP 1 Application and Management Plan for Participation in the Child and Adult Care Food Program (CACFP) |
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CACFP 2 Application/Center Information for the Child and Adult Care Food Program (CACFP) |
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Business Management Assessment Instructions |
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CACFP 205 Income Eligibility Form for Child Care Centers |
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CACFP 208 Statement of Affiliation, for not-for-profit organizations |
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CACFP 209 Application Budget – Child Care or Adult Day Care Center, Outside School Hours Center, Emergency Shelter or At-Rist After School Snack Program |
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CACFP 213 Daily Attendance Record |
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CACFP 214 Documentation of Non-profit Food Service (Updated - Summary of Salary Expenses) |
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CACFP 220 Enrollment Roster |
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CACFP 221 Time In/Time Out Record |
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CACFP 222 CACFP-222 Annual CACFP Training Documentation |
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CACFP 224 Monthly Attendance Time In/Time Out Record |
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CACFP 225 Meal Count (Monday thru Friday - letter size) |
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CACFP 225A Meal Count (Sunday thru Saturday - legal size) |
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CACFP 225B Shelter Meal Count (Sunday thru Saturday - letter size) |
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CACFP 227 Medical Food Substitution Record |
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CACFP 229 Enrollment Form for Child Care Centers |
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CACFP 230 CAP Fillable Form |
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SCCR-CACFP [Joint] Child Care Enrollment Form (MO 580-2994) |
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CACFP 404 Sponsored Centers Site Visit Report |
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CACFP 501 Income Eligibility Form for Adult Care Centers |
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Vendor Input/ACH-EFT Application – SAM II (required for new applicants and to change direct deposits) |
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CACFP Network User Access Request Form |
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Contracting for Food Service |
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Five Components in Menu Planning |
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Infant and Toddler Feeding and Care Plan for both Centers and Homes |
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Meal Count Record (Tally) for At-Risk Programs (150 Count Max) Microsoft Word (doc) is fillable! |
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Meal Count Record (Tally) for At-Risk Programs (300 Count Max) Microsoft Word (doc) is fillable! |
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Monthly Donated Food Log for Shelters |
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Non-Discrimination Policy Statement (Pricing Centers Only) |
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| Section for Child Care Regulation - Program Evaluation Questionnaire (CCR-20) | |
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Shelter Resident Roster by Month |
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Shelter Resident Roster by Period |