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
Action Planning
- Action Planning Form January 2022
- Addenda (Free and Reduced Applications)
- Addendum A: Sharing Information with Other Programs (English) June 2021
- Addendum A: Sharing Information with Other Programs (Spanish) June 2021
- Addendum B: Healthcare for Uninsured Kids and Youth (HUSKY) (English) June 2021
- Addendum B: Healthcare for Uninsured Kids and Youth (HUSKY) (Spanish) June 2021
- Addendum C: Information on the Supplemental Nutrition Assistance Program (SNAP) (English) February 2022
- Addendum C: Information on the Supplemental Nutrition Assistance Program (SNAP) (Spanish) February 2022
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)
- ASP Daily Attendance and Snack Count Record for Schools that are not Site/Area Eligible March 2022
- ASP Daily Snack Count Record for Grades K-12 in Site/Area Eligible Schools March 2022
- ASP Daily Snack Count Record for Preschoolers in Site/Area Eligible Schools March 2022
- ASP Daily Snack Count and Production Record for Grades K-12 in Site/Area Eligible Schools March 2022
- ASP Daily Snack Count and Production Record for Preschoolers in Site/Area Eligible Schools March 2022
- ASP Monthly Attendance and Snack Count Record for Schools that are not Site/Area Eligible March 2022
- ASP Monthly Attendance and Snack Count Record in Site/Area Eligible Schools March 2022
- ASP On-site Monitoring Form March 2022
- ASP Production Record for Ages 1-2 March 2022
- ASP Production Record for Ages 3-4 March 2022
- Sample Completed ASP Production Record for Ages 3-4 March 2022
- ASP Production Record for Grades K-12 March 2022
- ASP School Eligibility Checklist March 2022
Authorized Signatures
- Authorized Signatures Change Form April 2021
- Authorized Signatures Change Form Instructions April 2021
B
- Buy American Justification Form March 2022
C
Certification of Meal Pattern Compliance
Civil Rights
Community Eligibility Provision (CEP)
- Visit the "Documents/Forms" section of the CSDE's Community Eligibility Provision (CEP) webpage
Connecticut Nutrition Standards (CNS)
- CNS Worksheet 1: Evaluating Snacks for Compliance with the Connecticut Nutrition Standards February 2022
- CNS Worksheet 2: Evaluating Yogurt and Pudding for Compliance with the Connecticut Nutrition Standards February 2022
- CNS Worksheet 3: Evaluating Smoothies for Compliance with the Connecticut Nutrition Standards February 2022
- CNS Worksheet 4: Evaluating Fruits and Vegetables for Compliance with the Connecticut Nutrition Standards February 2022
- CNS Worksheet 5: Evaluating Soups for Compliance with the Connecticut Nutrition Standards February 2022
- CNS Worksheet 6: Evaluating Cooked Grains for Compliance with the Connecticut Nutrition Standards February 2022
- CNS Worksheet 7: Evaluating Entrees Sold Only A La Carte for Compliance with the Connecticut Nutrition Standards February 2022
- CNS Worksheet 8: Evaluating Non-entree Combination Foods for Compliance with the Connecticut Nutrition Standards February 2022
- CNS Worksheet 9: Nutrient Analysis of Recipes February 2022
- CNS Worksheet 10: Evaluating Recipes for Sugars February 2022
D
Disclosure Release
- Disclosure Release Request for Free or Reduced Eligibility Status of Students in the School Nutrition Programs July 2021
- USDA Memo SP 16-2016, CACFP 06-2016, SFSP 10-2016: Disclosure Requirements for the Child Nutrition Programs December 2015
District Benefit Issuance
- District Benefit Issuance Excel Spreadsheet (DBIES) February 2018
E
Edit Check Forms
- Community Eligibility Provision (CEP)
- CEP Edit Check Worksheet and Instructions February 2021
- NSLP and SBP
- Lunch: Edit Check Worksheet for Lunch February 2021
- Instructions for Edit Check Worksheet for Lunch February 2021
- Breakfast and Lunch: Edit Check Worksheet for Breakfast and Lunch February 2021
- Lunch: Edit Check Worksheet for Lunch February 2021
- Seamless Summer Option (SSO)
- Breakfast: SSO Closed Enrolled Sites Edit Check Worksheet for Breakfast September 2021
- Lunch: SSO Closed Enrolled Sites Edit Check Worksheet for Lunch September 2021
- Breakfast and Lunch: SSO Closed Enrolled Sites Edit Check Worksheet for Breakfast and Lunch September 2021
Equipment
- Capital Expenditure Approved List for School Food Authorities March 2022
- Equipment Purchase Approval Request Form March 2022
- Equipment Purchase Prior Approval Process for School Food Authorities March 2022
Exemption Requests
- COVID Waivers for School Year 2021-22 ("How To" section of CSDE's Operating Child Nutrition Programs during COVID-19 Outbreaks webpage)
- Lunch Period Waiver: Circular Letter C-9: Federal and State Requirements for Provision and Timeframe of Daily Lunch Period for Students November 2000
- Meal Pattern Exception Request Form for Residential Child Care Institutions (RCCIs) February 2022
- Weekend or Vacation Waiver: FNS 786-7 Rev. 2: Reimbursement for Meals and Milk Served on Weekends November 2010
F
Food Distribution Program (see USDA Foods)
Food Safety
- Alternate QFO Statement January 2021
- Food Service Employee Training Record for Sanitation and Food Safety April 2021
- On-site Training Record for Sanitation and Food Safety April 2021
- Qualified Food Operator (QFO) Responsibilities for Connecticut Child Nutrition Programs April 2021
- Refrigerator and Freezer Temperature Control Record April 2021
Food Service Management Company
- Exhibit I: Sample School Food Authority (SFA)/Food Service Management Company (FSMC) Monitoring Form April 2021
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
H
Healthy Food Certification (HFC)
- HFC Documentation Form 1: Purchased Foods and Beverages Sold in Cafeteria September 2019
- HFC Documentation Form 2: School-made Foods Sold in Cafeteria September 2019
- HFC Documentation Form 3: Foods and Beverages Sold in Vending Machines September 2019
- HFC Documentation Form 4: Foods and Beverages Sold in School Stores September 2019
- HFC Documentation Form 5: Food and Beverage Fundraisers September 2019
- HFC Documentation Form 6: Foods and Beverages Sold from Other Sources September 2019
- HFC Documentation Form 7: School-made Foods Sold from Other Sources September 2019
I
Interschool Agreements
- Full-service Interschool Agreement Form February 2022
- Recipient Site Vended Interschool Agreement February 2022
M
Meal Counting and Claiming
- Meal Application and Data Management Process Form March 2021
- Site Information on Money Collection and Point-of-Service (POS) Meal Count Systems Form March 2021
Media Release (see Public Media Release)
Medical Statement
- Medical Statement for Meal Modifications in School Nutrition Programs (English) March 2022
- Medical Statement for Meal Modifications in School Nutrition Programs (Spanish) March 2022
- Guidance and Instructions: Medical Statement for Meal Modifications in School Nutrition Programs (English) March 2022
- Guidance and Instructions: Medical Statement for Meal Modifications in School Nutrition Programs (Spanish) March 2022
Menu Forms for Preschoolers
- Breakfast Five-day Menu Planning Form for Ages 1-2 March 2022
- Breakfast Five-day Menu Planning Form for Ages 3-4 March 2022
- Breakfast Four-day Menu Planning Form for Ages 1-2 March 2022
- Breakfast Four-day Menu Planning Form for Ages 3-4 March 2022
- Breakfast Seven-day Menu Planning Form for Ages 1-2 March 2022
- Breakfast Seven-day Menu Planning Form for Ages 3-4 March 2022
- Lunch Five-day Menu Planning Form for Ages 1-2 March 2022
- Lunch Five-day Menu Planning Form for Ages 3-4 March 2022
- Lunch Four-day Menu Planning Form for Ages 1-2 March 2022
- Lunch Four-day Menu Planning Form for Ages 3-4 March 2022
- Lunch Seven-day Menu Planning Form for Ages 1-2 March 2022
- Lunch Seven-day Menu Planning Form for Ages 3-4 March 2022
Menu Planning Checklists for Lunch for Grades K-12
- Five-day Week Lunch Menu Planning Checklist: Grades K-5 March 2022
- Five-day Week Lunch Menu Planning Checklist: Grades 6-8 March 2022
- Five-day Week Lunch Menu Planning Checklist: Grades 9-12 March 2022
- Five-day Week Lunch Menu Planning Checklist: Grades K-8 March 2022
- Seven-day Week Lunch Menu Planning Checklist: Grades 6-8 March 2022
- Seven-day Week Lunch Menu Planning Checklist: Grades K-5 March 2022
- Seven-day Week Lunch Menu Planning Checklist: Grades 9-12 March 2022
- Seven-day Week Lunch Menu Planning Checklist: Grades K-8 March 2022
Monitoring Forms
- Onsite School Review Checklist for the NSLP February 2021
- Onsite School Review Checklist for the SBP February 2021
- Overview of Meal Counting and Claiming Process December 2021
- Seamless Summer Option (SSO) Sponsor Monitor Site Review Form January 2021
Nonprogram Foods
- Nonprogram Pricing Worksheet: Adult Meals August 2019
- Nonprogram Pricing Worksheet: A La Carte Sales August 2019
- Nonprogram Revenue Calculator (USDA) February 2019
- Nonprogram Revenue Tool for Five-day Reference Period (Kansas Department of Education) 2018
P
Paid Lunch Equity
- Paid Lunch Equity Calculations and Tool 2020-21 (USDA) March 2020
- Paid Lunch Equity Guidance: USDA Memo SP 07-2020: Paid Lunch Equity: Guidance for School Year 2020-21 January 2020
Policy Statement
- Policy Statement for Free and Reduced-price Meals, Afterschool Snack Programs, and Free Milk August 2021
Press Release (see Public Media Release)
Procurement
- Certification Regarding Debarment, Suspension, Ineligibility, and Voluntary Exclusion – Lower Tier Covered Transactions September 2019
- Sample Code of Conduct for Procurement September 2019
- Sample Procurement Procedures for School Food Authorities (Version 1) September 2019
- Sample Procurement Procedures for School Food Authorities (Version 2) September 2019
Production Records
- Visit the "Documents/Forms" section of the CSDE's Production Records for School Nutrition Programs webpage
Professional Standards
- Professional Standards Tracking Log January 2020
Public Media Release
- Sample Press Release CEP Sponsors Opting for the SSO August 2021
- Sample Public Media Release for Connecticut School Nutrition Programs August 2021
S
Seamless Summer Option (SSO)
- Visit the "Documents/Forms" section of the CSDE's Seamless Summer Option (SSO) of the NSLP webpage
Special Milk Program
- Visit the "Documents/Forms" section of the CSDE's Special Milk Program (SMP) webpage
Standardized Recipes
- Standardized Recipe Form for School Nutrition Programs February 2022
U
USDA Foods
- Unanticipated School Closures (CSDE) January 2022
- USDA Foods Transfer Request Form March 2022
- 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
- Yield Study Form for Child Nutrition Programs (CSDE) February 2022