Nutrition Programs
Child and Adult Care Food Program (CACFP) Forms and Documents
Program Fact Sheets
License Exemption Information—FY2011
Enrollment and Household Eligibility—July 1, 2011, through June 30, 2012
Meal Pattern Requirements and Nutrition Information
- Children Ages 1 to 12 Years
- Infants Birth thru 11 Months
- Menu Form (65-11A)
- Physician’s Statement for Food Substitutions (67-48)
- 21-Day Cycle Menu Form (65-11B)
- Sample 21-Day Cycle Menu
- Sample Snack Menus
- USDA Food Buying Guide For Child Nutrition Programs
Recordkeeping
- Adult Meal Participation Form (68-31)
- AFR Spreadsheet
(Fiscal Year 2012) - At-Risk After-School Snack/Supper Program Daily Meal Count Form (69-14)
- At-risk Verification Document (63-82)
- Cash Disbursements (67-24)
- Checklist of Annual Documents (69-02)
- Checklist for At-Risk Program
- Checklist for Profit Audit
- Checklist for Program Review
- Checklist of Monthly Documents (69-03)
- Food Donations (68-77)
- For-Profit Eligibility Form (67-91)
- Master List (67-95)
- Master List for Emergency Shelter (67-92)
- Master List for Head Start or Even Start (65-10)
- Meal Participation Record (68-75)
- Meal Participation Record – 31 Day Format (68-75A)
- Meal Participation Record for Emergency Shelter (69-04)
- Monthly Milk Purchase Estimate (68-50)
- Monthly Profit or Loss Summary (67-93)
- Personnel Activity Report (67-54)
- Total Meals Recap (67-22)
- Training Form (67-25)
Sponsoring Organizations
- At-Risk Monitor Form (67-77)
- Edit Checks 1 and 2 (65-09)
- Household Contact System
- Instructions for Adding a New Site
- Monitor Review Form (67-59)
- Preapproval Visit Form (67-60)
Vendor Contracts
- Invitation for Bid and Contract for Purchased Meals (69-99)
- Blank Breakfast Menu Form (67-04B)
- Blank Lunch/Supper Menu Form (67-04A)
- Blank Supplement Menu Form (67-04C)
- Small Purchase Agreement (67-89)
- School Agreement (68-62)
- Renewal of Competitively Bid Contracts (67-90)
- Certification Regarding Debarment (85-34)
- Vendor Listing
