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Forms for School Nutrition Programs
The list below includes forms for the School Breakfast Program, National School Lunch Program, Afterschool Snack Program, Seamless Summer Food Program and Special Milk Program.
A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z
A
- Afterschool Snack Program Application Addendum [PDF] Tab & Type [DOC]
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Afterschool Snack Program Application Addendum Instructions [ PDF]
- Afterschool Snack Daily Count Worksheet (Area Eligible) [PDF] [Excel]
- Afterschool Snack Daily Count Worksheet (Income Eligible) [PDF] [Excel]
- Afterschool Snack Program Menu Form 1 (ages 3-5) [PDF] [DOC]
- Afterschool Snack Program Menu Form 2 (ages 6-18) [PDF] [DOC]
- Afterschool Snack Program On-Site Monitoring Form [PDF]
- Annual Revenue and Cost Expenditure Report Form [PDF] [DOC]
- Instructions for Completing Annual Revenue and Cost Report Form [PDF]
- Application for Free, Reduced Price Meals or Free Milk: Family [PDF] [DOC]
- Authorized Signatures Change Form [PDF]
- Authorized Signatures Change Form Instructions [PDF]
C
- Collection Procedures Description [PDF] [DOC]
D
- Daily Milk Count Worksheet [PDF] [DOC] [Excel]
- Daily Milk Count Worksheet Instructions [PDF]
- Disclosure Release Request for Free or Reduced Eligibility Status [PDF] [DOC] New (January 2013)
E
- Edit Check Worksheet [PDF] [Excel]
- Edit Check Worksheet for Breakfast and Lunch [PDF] [Excel]
F
H
I
- Income Eligibility Guidelines 2012-13 [PDF]
- Interschool Agreement Full-Service [PDF] [DOC]
- Interschool Agreement Recipient Site Vended Form [PDF] [DOC]
M
O
- On-Site School Monitoring Sheet for Multiple Sites [PDF] [DOC]
P
S
V
CSDE School Nutrition Programs Staff Connecticut State Department of Education Bureau of Health, Nutrition, Family Services and Adult Education 25 Industrial Park Road, Middletown, CT 06457 Telephone: 860-807-2050 Fax: 860-807-2127
In accordance with Federal Law and U.S. Department of Agriculture policy, this institution is prohibited from discriminating on the basis of race, color, national origin, sex, age, or disability. To file a complaint of discrimination, write USDA, Director, Office of Adjudication, 1400 Independence Avenue, SW, Washington, D.C. 20250-9410 or call toll free 866-632-9992 (Voice). Individuals who are hearing impaired or have speech disabilities may contact USDA through the Federal Relay Service at 800-877-8339; or 800-845-6136 (Spanish). USDA is an equal opportunity provider and employer.
Content Last Modified on 1/23/2013 1:08:47 PM
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