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

Calendars

Program Forms for School Year 2022-2023 have been updated.

REMINDER: As 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 22-23 (English) (Spanish)
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)

Verifying Household Applications

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

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

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

Point of Service (POS) Sample Signage

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)
Food Distribution Program Delivery Information
Memorandum of Understanding (PDF) (Word)
Record Keeping List
Smart Snacks Calculator
Medical Statement for Students with Special Dietary Accommodations

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
- Manual ADD/CHANGE/DELETE Form (print, sign, scan and email)
- Electronic ADD/CHANGE/DELETE Web Form (access and fill out online, electronic signature)
  - The “Applicable Program” at the top of the form MUST be selected in order for the request to be processed.
  - The initiator of the form must also be an authorized signer.
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- Provision 2
  - Addendum- Provision 3
  - Addendum- Community Eligibility Provision (CEP)
  - Addendum- Non-Pricing
  - Addendum- RCCI without Day Students
  - Addendum – Special Milk Pricing
  - Public Media Release
  - Reimbursement Rates for SY 22-23

Public Media Release

Community Eligibility Provision (CEP)

Special Assistance Provisions 2 and 3

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

From the Health and Nutrition Services Blog

Congratulations to the School Year 2021-2022 BRAVOcado! Excellence Awardees! Tue, Oct 11 2022

The Arizona Department of Education Recognizes Schools for Exemplary Fresh Fruit and Vegetable Programs

The Arizona Department of Education Health and Nutrition Services is pleased to announce the Program Year 2021-2022 BRAVOcado! awardees for excellent Fresh Fruit and Vegetable Program (FFVP) operations. The BRAVOcado! Excellence Award is given to schools that demonstrate exemplary FFVP service and commitment to promoting fruit and vegetable consumption and healthy lifestyles to their students.

The FFVP BRAVOcado! Excellence Award recognizes schools that go above and beyond to operate a phenomenal FFVP program. To be eligible for the award, sites must meet criteria related to variety of produce items served, frequency of service, frequency of nutrition education, frequency of serving local produce, development of site-level and outside partnerships, and more!

The following three School Food Authorities went above and beyond and received the award this year. Congratulations to all awardees!

Concho Elementary School
Concordia Charter School
Southgate Academy, Inc.

2023 Farm Fresh Challenge Tue, Sep 20 2022

2023 Farm Fresh Challenge