CACFP Forms

Enrollment & Eligibility Forms & Resources

 
CACFP Forms
  CACFP Reimbursement Rates  

 

 

20

CACFP Enrollment Form

 

 

 

25

Income Eligibility Guidelines

 

 

 

75

Attendance Record

 

 

 
Child Care Forms
  Income Eligibility Form - Tier I

     
  Income Eligibility Form - Tier II

     

15-1

Notice to Households – Tier 1 Day Care Homes

     

15-2

Notice to Households – Tier 2 Day Care Homes

     

30

Child Care Income Eligibility Form

     

35N

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

     

35P

Notice to Households – Parents & Guardians (Pricing)

     

50

Child Care Master List


Adult Forms  

40

Income Eligibility Form – Adult Care

     

45

Notice to Households – Adult

     

55

Adult Master List

Word

PDF

-

   

Meal Patterns & Record Keeping Forms

 
CACFP Forms
 

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

 
 

Building for the Future Poster

-

PDF

-

CNP Password Form

-

PDF

-

Planned Monitoring Schedule

PDF

-
  Media Release Template    

170

Medical Statement Form

-

PDF

-

300

Site Review Forms for Sponsors

PDF

-

305

Monitoring Log

PDF

-

310

Training Certification Sheet

Word

PDF

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Page Last Updated on June 17, 2016