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School Nutrition Programs Forms

Forms and completed sample forms for use by School Nutrition Programs (SNP) sponsors.

Direct Certification (DOC)
Implementation checklist to establish procedures to directly certify student meal eligibility.

Disclosure of Lobbying Activities External link opens in new window or tab. (PDF)
U.S. Office of Management and Budget Standard Form LLL for disclosure of lobbying activities pursuant to 31 U.S.C. 1352.

Eligibility Materials
Applications, forms, and other materials for school meal, milk, and State Meal Program eligibility.

Food Distribution Forms

Inter-Agency Agreement (DOC)
This form is used to establish the conditions under which one School Food Authority will operate the National School Lunch Program and/or School Breakfast Program on behalf of another School Food Authority.

Meal Count Forms
Worksheets for School Nutrition Program meal counts.

Medical Statement to Request Special Meals and/or Accommodations (DOC)
CNP 925 - This form is used by parents/guardians to have a medical authority prescribe special meals or accommodations during meals.
Available translations of the Medical Statement to Request Special Meals and/or Accommodations for Child Nutrition Programs (Dated Aug-2017)

Menu Production Record Forms
Forms used to determine the amount of food to serve for School Meals Initiative (SMI) menu production.

Notification of Decision to Offer Fluid Milk Substitutes (DOC)
Used by schools choosing to offer a fluid milk substitute due to a medical or other special dietary need; see Management Bulletin USDA-CNP-04-2010 for more information.

Parental or Guardian Consent Form to Release the Household Meal Application to the CalFresh Program (DOC)
Used by schools to obtain parental or guardian consent to release the household meal application to the local CalFresh office to initiate enrollment of the student's family in the CalFresh program.
Available Translations of Parental or Guardian Consent Form to Release the Household Meal Application to the CalFresh Program

Provision Forms (Claiming Alternatives)
Forms for the School Nutrition Programs special assistance alternatives, known as Provisions 1, 2, and 3.

Seamless Summer Feeding Option Materials
Forms for the federal seamless option opportunity that allows public schools to combine features of the School Nutrition Programs and the Summer Food Service Program along with reduced paperwork requirements.

Verification Materials
School Nutrition Programs verification materials including applications, forms, and other materials for the annual, mandatory verification process for eligibility of a sample of completed household meal eligibility applications in schools.

Waiver Forms
The CDE Attachment for Waivers page; see Summer School Meal section for summer school meal waiver forms. For Saturday school meal waivers, use the CDE Waiver Request System.

Questions:   Nutrition Services Division | 800-952-5609
Last Reviewed: Wednesday, November 15, 2017
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