Forms for School Nutrition Programs

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Forms for School Nutrition Programs

Overview

School Nutrition Programs | Manuals | Program Guidance | Resources | Nutrition Education

The forms below are for the U.S. Department of Agriculture's (USDA) school nutrition programs, including the School Breakfast Program (SBP), National School Lunch Program (NSLP), Seamless Summer Option (SSO) of the NSLP, Afterschool Snack Program (ASP) of the NSLP, Fresh Fruit and Vegetable Program (FFVP), and Special Milk Program (SMP). For guidance on program requirements, visit the CSDE's Program Guidance for School Nutrition Programs webpage.

Note: The date in italics after each document is the most current revision date.

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

A la Carte Food Cost and Price Charged Comparison Worksheet: Visit the "Nonprogram Foods" section of the CSDE's Financial Management for School Nutrition Programs webpage
Action Planning Form January 2022
Addenda (Free and Reduced Applications): Visit the "Documents/Forms" section of the CSDE's Eligibility for Free and Reduced-price Meals and Free Milk in School Nutrition Programs webpage
Administrative Review

Menu Documentation Organizational Tool (MDOT) January 2020
Sample Administrative Review Organizational Tool (AROT) January 2020
Sample Administrative Review Organizational Tool (AROT) for Residential Child Care Institutions (RCCIs) and 100 Percent Community Eligibility (CEP) Districts January 2020

Afterschool Snack Program (ASP): Visit the "Documents/Forms" section of the CSDE's Afterschool Snack Program webpage
Application for Free and Reduced-price School Meals or Free Milk: Visit the "Documents/Forms" section of the CSDE's Eligibility for Free and Reduced-price Meals and Free Milk in School Nutrition Programs webpage
Authorized Signatures: Authorized Signatures Change Form and Instructions February 2023

B

Buy American Justification Form February 2023

C

Certification of Meal Pattern Compliance: Visit the "Document/Forms" section of the CSDE's Certification of Meal Pattern Compliance for School Nutrition Programs webpage
Civil Rights: Visit the "School Nutrition Programs" section of the CSDE's Civil Rights for Child Nutrition Programs webpage
- Sample Civil Rights Complaint Procedures for School Nutrition Programs February 2023
- Sample Taglines Form February 2023
Community Eligibility Provision (CEP): Visit the "Documents/Forms" section of the CSDE's Community Eligibility Provision (CEP) webpage
Connecticut Nutrition Standards (CNS) Worksheets: Visit the "How to" section of the CSDE's CNS webpage

D

Disclosure Release: Disclosure Release Request for Free or Reduced Eligibility Status of Students in the School Nutrition Programs February 2023
- USDA Memo SP 16-2016, CACFP 06-2016, SFSP 10-2016: Disclosure Requirements for the Child Nutrition Programs
District Benefit Issuance: District Benefit Issuance Excel Spreadsheet (DBIES) April 2023

E

Edit Check Forms: Visit the "Documents/Forms" section of the CSDE's Meal Counting and Claiming for School Nutrition Programs webpage
Equipment Purchase Approval Request Form: Visit the "Capital Expenditure Requests and Equipment Approvals" section of the CSDE's Financial Management for School Nutrition Programs webpage
Exemption Requests
- Lunch Period Waiver: Circular Letter C-9: Federal and State Requirements for Provision and Timeframe of Daily Lunch Period for Students
- Meal Pattern Exception Request Form for Residential Child Care Institutions (RCCIs) February 2023
- Weekend or Vacation Waiver: FNS 786-7 Rev. 2: Reimbursement for Meals and Milk Served on Weekends

F

Family Application for Free and Reduced-price School Meals or Free Milk: Visit the "Documents/Forms" section of the CSDE's Eligibility for Free and Reduced-price Meals and Free Milk in School Nutrition Programs webpage
Food Distribution Program (see USDA Foods)
Food Service Management Company: School Food Authority/Food Service Management Company Monitoring Form January 2023
Free and Reduced-price Meals: Visit the "Documents/Forms" section of the CSDE's Eligibility for Free and Reduced-price Meals and Milk in School Nutrition Programs webpage
Fundraisers: Sample Fundraiser Form for Healthy Food Certification (HFC) February 2023

H

HFC Documentation Forms: Visit the "Documents/Forms" section of the CSDE's HFC webpage

I

Interschool Agreements

Full-service Interschool Agreement Form February 2023
Recipient Site Vended Interschool Agreement February 2023

M

Meal Count Forms: Visit the "Documents/Forms" section of the CSDE's Meal Counting and Claiming for School Nutrition Programs webpage
Meal Counts
- Meal Application and Data Management Process Form February 2023
- Site Information on Money Collection and Point-of-Service Meal Count Systems Form February 2023
Media Release (see Public Media Release)
Medical Statements: Visit the "Documents/Forms" section of the CSDE's Special Diets in School Nutrition Programs webpage
Menu Forms for Preschoolers: Visit the "Documents/Forms" section of the CSDE's Meal Patterns for Preschoolers in School Nutrition Programs webpage
Menu Planning Checklists for Lunch for Grades K-12
- Five-day Week Lunch Menu Planning Checklist: Grades K-5 February 2023
- Five-day Week Lunch Menu Planning Checklist: Grades 6-8 February 2023
- Five-day Week Lunch Menu Planning Checklist: Grades 9-12 February 2023
- Five-day Week Lunch Menu Planning Checklist: Grades K-8 February 2023
- Seven-day Week Lunch Menu Planning Checklist: Grades 6-8 February 2023
- Seven-day Week Lunch Menu Planning Checklist: Grades K-5 February 2023
- Seven-day Week Lunch Menu Planning Checklist: Grades 9-12 February 2023
- Seven-day Week Lunch Menu Planning Checklist: Grades K-8 February 2023
Monitoring Forms
- ASP: Afterschool Snack Program (ASP) On-site Monitoring Form February 2023
- FSMC: School Food Authority/Food Service Management Company Monitoring Form February 2023
- NSLP: School Food Authority On-site Review Checklist for the National School Lunch Program February 2023
- SBP: School Food Authority On-site Review Checklist for the School Breakfast Program February 2023
- SSO: Seamless Summer Option (SSO) Sponsor Monitor Site Review Form February 2023
- Overview of Meal Counting and Claiming Process February 2023

N

Nonprogram Foods Pricing Worksheets (Adult Meals and A La Carte Sales): Visit the "Nonprogram Foods" section of the CSDE's Financial Management for School Nutrition Programs webpage

P

Paid Lunch Equity: Visit the "Paid Lunch Equity" section of the CSDE's Financial Management for School Nutrition Programs webpage
Parent/Guardian Notification Letters (Free and Reduced Applications): Visit the "Documents/Forms" section of the CSDE's Eligibility for Free and Reduced-price Meals and Free Milk in School Nutrition Programs webpage
Policy Statement for Free and Reduced-price Meals, Afterschool Snack Programs, and Free Milk August 2022
Press Release
- Sample Press Release for the SSO February 2023
- Sample Public Media Release for Connecticut School Nutrition Programs June 2023
- Sample Public Media Release for Connecticut School Nutrition Programs: STABLE Funds Version August 2023
Procurement: Visit the "Documents/Forms" section of the CSDE's Procurement for School Nutrition Programs webpage
Production Records for Grades K-12 in the NSLP and SBP: Visit the "Documents/Forms" section of the CSDE's Production Records for School Nutrition Programs webpage
Production Records for Preschoolers in the NSLP, SBP and ASP: Visit the "Documents/Forms" section of the CSDE's Meal Patterns for Preschoolers in School Nutrition Programs webpage
Production Records for the Afterschool Snack Program (ASP): Visit the "Documents/Forms" section of the CSDE's ASP webpage
Professional Standards Tracking Log February 2023

R

Refrigerator and Freezer Temperature Control Record March 2023

S

Seamless Summer Option (SSO) of the NSLP: Visit the "Documents/Forms" section of the CSDE's SSO webpage
Snack Count Forms for the ASP (Not Site Area Eligible): Visit the "Documents/Forms" section of the CSDE's ASP webpage
Snack Count Forms for the ASP (Site Area Eligible): Visit the "Documents/Forms" section of the CSDE's ASP webpage
Special Milk Program (SMP): Visit the "Documents/Forms" section of the CSDE's SMP webpage
Standardized Recipe Form for School Nutrition Programs February 2023

USDA Foods
- USDA Foods Transfer Request Form February 2023
- USDA Foods Order and Donation Forms: Visit the "Order and Donation Forms for COVID-19-related Excess Direct Delivery Inventory at HPC" section of the CSDE's Food Distribution Program webpage
- USDA Foods Ordering Worksheets: Visit the "Web-Based Supply Chain Management (WBSCM)" section of the CSDE's Food Distribution Program webpage

V

Verification: Visit the "Documents/Forms" section of the CSDE's Verification Procedures for School Nutrition Programs webpage

Y

Yield Study Form for Child Nutrition Programs (CSDE) February 2023