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
| USDA Requirements (5 day) | |
| USDA Requirements (7 day) | |
3 Meal Menu Template (5 day) |
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| 5 Meal Menu Template (5 day) | |
| 5 Meal Menu Template (7 day) | |
| At-Risk Snack & Supper Menu Template (5 day) | |
| At-Risk Snack & Supper Menu Template (7 day) | |
| Individual Infant Meal Record, Birth to 5 Months (5 Day) | |
| Individual Infant Meal Record, Birth to 5 Months (7 Day) | |
| Individual Infant Meal Record, 6 to 11 Months (5 Day) | |
| Individual Infant Meal Record, 6 to 11 Months (7 Day) |
Food Charts
CACFP Applications & Forms
| Annual CACFP Training Documentation (CACFP 222) | ||
| web | Annual Subrecipient Information Form | |
| Beneficiary Data Report (CACFP/SFSP-226) | ||
| Corrective Action Form (CACFP/SFSP-409) | ||
| xls | Daily Attendance Record (CACFP 213) | |
| Daily Meal Receiving Log | ||
| Documentation of Nonprofit Foodservice (CACFP 214) | ||
| Donated Food Log (CACFP/SFSP-670) | ||
| Enrollment Form for Adult Day Care Centers (CACFP 635) | ||
| Enrollment Form for Child Care Centers (CACFP 229) | ||
| Enrollment Form for Child Care Centers (Office of Childhood/CACFP shared) | ||
| doc | Enrollment Roster (CACFP 220) | |
| Five Components in Menu Planning | ||
| Grain Requirements for the Child and Adult Care Food Program | ||
| Income Eligibility Form for Adult Care Centers (CACFP 501) | ||
| Income Eligibility Form for Child Care Centers (CACFP 205) | ||
| Infant and Toddler Feeding and Care Plan for both Centers and Homes | ||
| Meal Communication and Credit Log | ||
| doc | Meal Count (Monday thru Friday - letter size) (CACFP 225) | |
| doc | Meal Count (Sunday thru Saturday - legal size) (CACFP 225A) | |
| Meal Count Consolidation (CACFP 653) | ||
| Meal Count Record (Tally) for At-Risk Programs (150 Count Max) | ||
| Meal Count Record (Tally) for At-Risk Programs (300 Count Max) | ||
| Medical Statement to Request Special Meals and or Accommodations (CACFP 227) | ||
| doc | Monthly Attendance Time In/Time Out Record (CACFP 224) | |
| doc | Monthly Donated Food Log for Shelters | |
| Network User Access Request | ||
| Non-Discrimination Policy Statement (Pricing Centers Only) | ||
| Outreach and Beneficiary Data Survey | ||
| doc | Shelter Meal Count (Sunday thru Saturday - letter size) (CACFP 225B) | |
| doc | Shelter Resident Roster by Month | |
| doc | Shelter Resident Roster by Period | |
| Sponsored Centers Site Visit Report – Review by Sponsor (CACFP 404) | ||
| Sponsoring Organization Household Contact Survey | ||
| doc | Statement of Affiliation, for not-for-profit organizations (CACFP 208) | |
| doc | Time In/Time Out Record (CACFP 221) | |
| Vendor Input/ACH-EFT Application – SAM II (required for new applicants and to change direct deposits) |