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School Nutrition Programs Forms

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

Direct Certification (DOC; 47KB; 1p.)
Implementation checklist to establish procedures to directly certify student meal eligibility.

Disclosure of Lobbying Activities (PDF; Outside Source)
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

Food Service Contracts

Food Service Management Company Service Procurement

Explains regulations regarding procurement of services offered by a food service management company (FSMC).
Food Service Consulting Contract Prototype (DOC; 93KB; 12pp.)
Price Quote for Procurement of Food Service Management Services (DOC; 36KB, 1p.)

Inter-Agency Agreement (DOC; 60KB; 1p.)
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; 67KB; 2pp.)
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.

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

Provisions (Claiming Alternatives)

Claiming Alternatives Implementation Request (DOC; 143KB; 3pp.)
Policy Statement Addendum to amend certain provisions and procedures to reflect current practices for schools requesting to participate in Provision 1, 2, and/or 3.
Request for a Streamlined Base Year Provision 2 (DOC; 82KB; 2pp.)
Provision 2 and 3 Extension Request (DOC; 66KB; 1p.)
Provision 2/3 Extension Request Worksheet (XLS; 30KB; 1p.)
Provision 2 Calculation Guide (DOC; 96KB; 3pp.)

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.

Site Monitoring

Lunch Sites (DOC; 114KB; 2pp.)
Agencies with more than one site must complete a LUNCH site monitoring review for EACH site annually, prior to February 1.
After School Snack Sites (DOC; 124KB; 2pp.)
Sponsor must complete 2 site monitoring reviews for each site per program year, with intervals no greater than six months.
Provisions 2 & 3 Sites (DOC; 80KB; 2pp.)
For lunch sites that use alternative meal claiming procedures known as Provisions 2 and 3.

Snack Enrollment Roster (DOC; 47KB; 1p.)
Snack enrollment roster form.

Verification Materials (Updated 10-Dec-2008)
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
New conditions for summer and Saturday school meal waivers criteria.

Questions:   Nutrition Services Division | 800-952-5609
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This institution is an equal opportunity provider.
Esta institución es un proveedor igual de la opportunidad.