Child and Adult Care Food Program
Forms

Most Requested Forms

• Civil Rights Complaint Procedure (Word)
• CACFP User Authorization form (PDF)
• Statewide Payee Registration (Word)
• Food Service Vendor Agreement (PDF)
• Child Care Site Review Form (PDF)
• Adult Care Site Monitoring Form (Word)
• Child Care Enrollment Roster (Word)
• Child Care Enrollment Data Summary (Word)
• Parent/Guardian Request for Fluid Milk Substitution (Word)
• Infant Formula Offer (PDF)
• Provider Transfer Form (Word)
• Medical Disability Statement for Food Substitution(s) (Word)
• Medical Non-Disabling Statement for Food Substitution(s) (Word)

Child Care Institutions Forms

• Renewal Instructions for Federal Fiscal Year (B035-12)
• Enrollment and Income-Eligibility Instructions for Federal Fiscal Year 2013 (B023-12)
  • Enrollment/Income Eligibility Application (Attachment 2)
  • Enrollment Form (Attachment 3)
  • Letter to Parents (Attachment 4)
  • Income Guidelines (Attachment 5)
  • Attendance Roster (Attachment 6)
  • Study Month Summary (Attachment 7)

Child Care Institutions (Spanish Forms)

• Solicitud de Inscripción/Elegibilidad por Ingreso (Word)
• Formulario de Inscripción (Word)
• Suggested Ltr.—Muestra Sugerida de Carta Dirigida a Padres de Familia (Word)

Adult Care Institutions Forms

• Renewal Instructions - Federal Fiscal Year 2013 (B036-12)
• Enrollment and Income-Eligibility Instructions for Federal Fiscal Year 2013 (B024-12)
  • Income-Eligibility Application (Attachment 2)
  • Letter to Participants (Attachment 3)
  • Income Guidelines (Attachment 4)
  • Attendance Roster (Attachment 5)
  • Study Month Summary (Attachment 6)

Family Day Care Home Sponsors

• Family Day Care Home Forms for New and Renewing Sponsor/Provider Agreement Federal FY 2013 (B016-12)
• Renewal Instructions for Federal FY 2013 (B034-12)