National School Lunch Program and School Breakfast Program - Program Forms and Resources

Calendars and Checklists

Calendars

• NSLP At a Glance Calendar
• NSLP At a Glance Calendar for Special Provision Options
• Verification Best Practices Calendar
• Claiming Calendar

Checklists

• School Meal Programs Application and USDA Foods Checklist

Eligibility Documents for School Meal Benefits

REMINDER: Per USDA, the Program Forms should be distributed on or around the beginning of the school year. *Forms cannot be distributed before July 1.

Application Packet

• Parent Letter for School Meals (English) (Spanish)
• Instructions for Household Application for Free and Reduced-Price Meals (English) (Spanish)
• Household Application for Free and Reduced-Price Meals (English) (Spanish)
• Parent/Guardian Consent for Sharing Information (English) (Spanish)
• Foster Outreach Letter – USDA Sample Template (PDF) (Word)
• USDA Translated School Meal Application Materials

Parent Letters for Special Provision Options

• Parent Letter for Provision 2/3 Non-Base Year & for CEP (English) (Spanish)

Parent Letters for the Special Milk Program

• Parent Letter collects applications and charges (English) (Spanish)
  • *Use the instructions and the household application for free and reduced-price meals posted above.
• Parent Letter,does not collect applications and charges (English) (Spanish)
• Parent Letter, does not collect applications and does not charge (English) (Spanish)

Certification and Benefit Issuance

• Income Eligibility Guidelines (IEGs) for SY 23-24
• Income Eligibility Guidelines (IEGs) for SY 24-25
• Income Eligibility Guidelines (IEGs) for SY 25-26
• Notification of Benefits Letter, School Meals (English) (Spanish)
• Notification of Benefits Letter, Special Milk (English) (Spanish)
• Notification for Free School Meals Letter, Direct Certification (English) (Spanish)
• Notification of Reduced-Price School Meals Letter, Direct Certification - Medicaid (English) (Spanish)

Verifying Household Applications

• Student Eligibility Checklist
• Error-Prone Guidelines (PDF) (Excel)
• Verification Tracking Form
• Verification for Cause Tracking Form
• Notification of Verification Letter (English) (Spanish)
• Letter of Verification Results (English) (Spanish)
• It's More Than a Meal Application (English)  (Spanish)
• Sources of Acceptable Income (English) (Spanish)
• Second Review Aggregate Tool

Financial

• Adult Meal Pricing Tool
• Attendance Factor Calculation Form
• Capital Expenditure Pre-Approval Request Form (Pre-Approved List)
  • Complete and submit form via HelpDesk using HNS Service Request – Other – Select: Capital Expenditure Pre-Approval Request Form
• CNP Procurement Procedures 
• CNP Written Code of Conduct
• Common Logon Form (Adobe Sign)
• Non-Program Food Revenue Tool & Calculator
• Paid Lunch Equity (PLE) Tool
• Net Cash Resources Worksheet (PDF)
• Excess Cash Spending Plan
• Request for One-Time Exception Form
• State of Arizona W-9 Form
• State of Arizona ACH Authorization Form

Food/Health Safety

• Prototype (Template) Hazard Analysis Critical Control Point (HACCP) Food Safety Plan
• Cooler Freezer Temperature Log
• Cooling Study Temperature Log
• Damaged Discarded Product Log
• Dish Machine Temperature Log
• Dry Storage Temperature Log
• Milk Cooler and Cleaning Temperature Log
• Receiving Log
• Reporting Issues with USDA Foods
• Sanitizer Test Strip Log
• Thermometer Calibration Log

Fresh Fruit and Vegetable Program (FFVP)

• Orientation to the Fresh Fruit and Vegetable Program
• FFVP Addendum to the Food Program Permanent Service Agreement
• FFVP Letter for Teachers Template
• FFVP Standard Operating Procedure (SOP) Template
• FFVP Production Record Template
• FFVP Site Self-Monitoring Form
• FFVP Labor Log Template
• FFVP Monthly Service Planner SY 24-25

Local Wellness Policy

• Local Wellness Policy Fillable Template
• ADE Activity and Assessment Tool (District version) (School version)
• Local Wellness Policy Assessment Comparison with a Model Policy
• Local Wellness Policy Assessment Reporting Template: 4-box Design School & District Template
• Local Wellness Policy Assessment Reporting Template: Wellness Report Card (District or school template) (Sample)

Menu Planning

• Production Record (with menu contributions) (PDF)
• Production Record (no menu contributions) (PDF)
• Production Record for Multiple Grades (PDF) (Word)
• Production Record for Afterschool Care Snack Program (PDF)
• Standardized Recipe Template
• Vegetable Subgroup Planner
• Vegetable Subgroup Quick Guide

Crediting Meal Components

• Fresh Fruit Portion Guide
• Fresh Vegetable Portion Guide
• Fruit Resource for the National School Lunch and School Breakfast Programs
• Milk Resource for the National School Lunch and School Breakfast Programs
• Meat and Meat Alternatives Resource for the National School Lunch and School Breakfast Programs
• Vegetable Resource for the National School Lunch and School Breakfast Programs
• Whole Grain Resource for the National School Lunch and School Breakfast Programs
• How to Credit Grains Using the Food Buying Guide

Weekly Menu Planners (Includes 3-Day, 4-Day, 5-Day, 6-Day, 7-Day Planners)

• Breakfast Weekly Menu Planner
• Lunch Weekly Menu Planner

Point of Service (POS) Sample Signage

• USDA OVS Posters and Tip Sheets
• Offer vs. Serve Poster – Sample from Connecticut Department of Education
• Serve Only Sign - Lunch
• Offer vs. Serve Sign - Lunch
• Serve Only Sign - Breakfast
• Offer vs. Serve Sign - Breakfast

Operational

• Buy American Exception Form
• Fundraising Exemption Request
• Internal On-Site Monitoring Form - Afterschool Care Snack Program
• Internal On-Site Monitoring Form – Breakfast
• Internal On-Site Monitoring Form – Lunch
• Daily Edit Check Worksheet (for sites operating regular NSLP and Special Assistance Provision Base Year)(PDF) (Excel)
• Simplified Daily Edit Check Worksheet (for sites operating CEP and Special Assistance Provision Non-Base Year)(PDF) (Excel)
• Memorandum of Understanding (PDF) (Word)
• Record Keeping List
• Smart Snacks Calculator
• Medical Statement for Students with Special Dietary Accommodations (English) (Spanish)

Organizational

• Access to CNP Applications Guidance (CNPWeb, CNP Direct Certification / Direct Verification, and CNP Verification)
  • *Don’t have an Entity Administrator? Fill out this form.
• Health and Nutrition Services Entity Data Form
  • HelpDesk Add/Change/Delete
    • Log into ADEConnect
    • Click 'Help'
    • Click 'Go to Help Desk'
    • Click 'New Request'
    • Locate Health and Nutrition Services templates
    • Select 'HNS Add/Change/Delete Form'
    • Complete all required fields and applicable optional fields within HelpDesk's Add/Change/Delete form
    • *User/Requestor submitting Add/Change/Delete form must be submitted by an Authorized Signer listed on the Food Permanent Service Agreement
  • Manual Add/Change/Delete Form (print, sign, scan, and email)
• Food Program Permanent Service Agreement (FPPSA)
  • Manual FPPSA (print, sign 1 original, mail to ADE for approval)
    • HNS #11-2020: Revised Instructions for FPPSA for School Food Authorities (SFAs)
  • Electronic FPPSA (complete initiation form, agreement is emailed to signers directly by AdobeSign, electronic signature)
    • HNS #11-2020: Revised Instructions for FPPSA for School Food Authorities (SFAs)
    • FPPSA Initiation Form for AdobeSign
• Free and Reduced Price Policy Statement
  • If applicable to your operation, please also include:
    • SFA At-Risk Afterschool Meals Responsible Principals Addendum (PDF)
    • Addendum- Non-Pricing
    • Addendum- RCCI without Day Students
    • Addendum – Special Milk Pricing
    • Public Media Release
    • Reimbursement Rates for SY 24-25
• Unique Entity Identifier (UEI) lookup or request a UEI by visiting https://sam.gov/content/duns-uei

Outreach

• Public Media Release

Professional Standards

• Training Tracker (Director)
• Training Tracker (Manager)
• Training Tracker (Full-Time Staff)
• Training Tracker (Part-Time Staff)
• Training Tracker (Non-Program Staff)
• Hiring Tracker for Directors Hired after July 1, 2015 (10,000+ enrollment)
• Hiring Tracker for Directors Hired after July 1, 2015 (2,500-9,999 enrollment)
• Hiring Tracker for Directors Hired after July 1, 2015 (less than 2,499 enrollment)

Special Provision Options

Community Eligibility Provision (CEP)

• CEP Application Information
• CEP Participation Form
• CEP Eligibility Worksheet
• CEP Monthly Federal Reimbursement Estimator (Excel)
• CEP Grouping Calculator
• CEP Parent Outreach Letter
• Annual Identified Student Percentage (ISP) Form
• ISP Calculation Worksheet for LEAs
• CEP Fact Sheet

Special Assistance Provisions 2 and 3

• Financial Analysis Tool
• Special Assistance Application
• Special Assistance Extension Application Packet

Free and Reduced Priced Policy Statement Addendums

• Addendum- Provision 2
• Addendum- Provision 3
• Addendum- Community Eligibility Provision (CEP)

Vendor Contracts

• Inter-Agency Agreement (Checklist) (Template)
• Informal Catering Contract Agreement (Checklist) (Template) 
• Sample Catering Specifications and Requirements
• Certificate of Independent Price Determination