Forms

   

Download forms for the following:

   
   
ENROLLMENT & ELIGIBILITY FORMS & RESOURCES
   
 
CACFP Forms

Form ID

Form Name

PDF


  CACFP Reimbursement Rates
-

PDF

-

20

CACFP Enrollment Form

-

PDF

-

25

Income Eligibility Guidelines

-

PDF

-

75

Attendance Record

-

PDF

         
Child Care Forms
  Income Eligibility Form - Tier I
(NOTE: Print on light green)
-
-
  Income Eligibility Form - Tier II
(NOTE: Print on lavender)
-
-

15-1

Notice to Households – Tier 1 Day Care Homes

PDF

-

15-2

Notice to Households – Tier 2 Day Care Homes

PDF

-

30

Child Care Income Eligibility Form
(NOTE: Print on tan)

-

PDF

-

35N

Notice to Households – Parents & Guardians (Non-pricing)

PDF

-

35P

Notice to Households – Parents & Guardians (Pricing)

PDF

-

50

Child Care Master List

Excel

         
Adult Forms  

40

Income Eligibility Form – Adult Care
(NOTE: Print on white)

-

PDF

-

45

Notice to Households – Adult

PDF

-

55

Adult Master List

Word

PDF

-

 
   
MEAL PATTERNS & RECORD KEEPING FORMS
   
 
CACFP Forms

Form ID

Form Name

PDF


 

Meal Planning Templates

Word

-
 

Non-creditable Foods List

-

PDF

-

120

Meal Count Sheet

Word

PDF

120FRP

Meal Count Sheet by Category

Word

PDF

-
         
Child Care Forms

180

Child Care Meal Pattern

-

PDF

-

100

Child Weekly Meal Record

Word

PDF

100S

Child Supper & Evening Snack Record

Word

PDF

-

110

Child Snack Record

Word

PDF

Excel

150

Expenditure Report

-

PDF

165

Infant Meal Pattern

-

PDF

-

115

Child Breakfast & Snack Record

Word

PDF

160A

Infant Meal Record (0-3 months)

Word

PDF

-

160B

Infant Meal Record (4-7 months)

Word

PDF

-

160C

Infant Meal Record (8-11 months)

Word

PDF

-
         
Adult Forms

210

Adult Meal Pattern

-

PDF

-

200A

Adult Weekly Meal Record

Word

PDF

-

200S

Adult Supper & Evening Snack

Word

PDF

-
 
   
PROGRAM ADMINISTRATION
   
 

Form ID

Form Name

PDF


 

Building for the Future Poster

-

PDF

-

CNP Password Form

-

PDF

-

Planned Monitoring Schedule

PDF

-

170

Medical Statement Form

-

PDF

-

300

Site Review Forms for Sponsors

PDF

-

305

Monitoring Log

PDF

-

310

Training Certification Sheet

Word

PDF

-

 

Page Last Updated on February 25, 2014