Adult Component Eligibility Materials
Participant eligibility materials for the adult component of the Child and Adult Care Food Program (CACFP).
Child Care Center Eligibility Materials
Participant eligibility materials for the child care component of the CACFP.
Certification
of Principals and Board Members (DOC; Dated Feb-2004)
Form used to gather information from principals in organizations
applying or reapplying to participate in the Child and Adult Care
Food Program. (See Management Bulletin 04-201 for more information.)
Day Care Home Eligibility Materials
Provider and participant eligibility materials for the day care home component of the CACFP.
Day Care Home Provider Drop/Transfer Form (DOC; Dated Jun-2008)
Provider form to terminate agreement with current sponsor and be dropped from the CACFP.
Disclosure
of Lobbying Activities
(PDF; Dated Jul-1997)
U.S. Office of Management and Budget Standard Form LLL. Complete
this form to disclose lobbying activities pursuant to 31 U.S.C.
1352.
Emergency Shelter Daily Roster (DOC; Dated Apr-2012)
Used to record the meals served to the eligible shelter residents.
Emergency Shelter Monthly Roster (DOC; Dated Apr-2012)
Used to document adults with disabilities that may be served and claimed,
provided that the shelter serves a majority of residents 18 years of age or younger.
Medical Statement to Request Special Meals and/or Accommodations (DOC; Dated Jun-2012)
CNP 925 - This form is used by parents/guardians to have a medical authority prescribe special meals, or accommodations during meals, which are necessary because of a disability or medical reason.
Available Translations of the Medical Statement to Request Special Meals and/or Accommodations (Dated Jun-2012)
Parental Request for a Fluid Milk Substitution for Children in Child Care (DOC; Dated Dec-2011)
Used by parents to request a fluid milk substitute due to a medical or other special dietary need; see MB USDA-CACFP-20-2011 for more information.
Site
Monitoring Report (DOC; Dated May-2012)
Form used to monitor program operations in centers at least three
times each year, with no more than six months between monitoring
visits. (See Management Bulletin 01-204 for more information.)
Standard Agreement Between
Sponsor and Provider (DOC; Dated Jul-2010)
Sample permanent agreement between a sponsoring organization and
a day care home provider. (See Management Bulletin 05-209 for
more information.)
Training
Report (DOC; Dated Apr-2012)
Form used to report annual training that, at minimum, meets federal
program requirements for staff at all of sponsored centers. (See
Management Bulletin 01-204 for more information.)
