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Child and Adult Care Food Program


Note: 2012-2013 Application Due Date is November 30, 2012.

Form Format
Application Documents - UPLOADS ALL PROGRAMS
Application Upload Documents Attachments to the Application for Participation - Sponsors, Word document
Administrative Budget Worksheets Word document
Application Certification Signature Page Word document
CACFP Forms
Categorical Eligibility 2013 ategorical Eligibility 2009, Word document
Center Monitoring Review Form Center Monitoring Review Form, Word document
Child and/or Adult Enrollment Form Acrobat Reader
FDCH Forms
FDC Home Monitoring Review Form FDC Home Monitoring Review Form, Word document
Provider Appeals Process Acrobat Reader
Parent/Guardian Application and Directions
Adult Client Application Word document
Adult Client Application Directions Word document
Adult Client Guardian Letter Word document
Child and/or Adult Enrollment Form Acrobat Reader
Parent Application -CACFP, FDC Tier I/Tier II, Provider Tier I/Tier II Parent Application (CACFP, FDC Tier I/Tier II, Provider Tier I/Tier II), Word document
Parent Application Directions - CACFP, FDC Tier I/Tier II, Provider Tier I/Tier II Parent Application Directions (CACFP, FDC Tier I/Tier II, Provider Tier I/Tier II), Word document
Parent Letter - CACFP Word document
Provider Letter - Tier I Word document
Provider Letter - Tier II Word document
Tier I and II - Notification Tier I and II - Notification, Word document
Tier I and II - Selection for Verification Tier I and II - Selection for Verification, Word document
Provider Forms
New Provider Determination Tier I Income Worksheet New Provider Determination Tier I Income Worksheet, Acrobat Reader
Provider Application and Agreement Provider Application and Agreement, Word document
Provider Application Instructions Provider Application Instructions, Word document
Provider Tier II-Tier I Eligibility and Notification Provider Tier II-Tier I Eligibility and Notification, Word document
Additional Forms
FDCH Menu Reimbursement Worksheet/Menu form Excel
5 Day Reconciliation Form - Child Care Centers ONLY Acrobat Reader
5 Day Reconciliation Form Policy and Procedure of Meal Counts 5 Day Reconciliation Form, Acrobat Reader
5 Day Reconciliation Form - Family Day Care Homes ONLY Acrobat Reader
50% Eligibility List February 15, 2014 50% Eligibility List, Acrobat Reader
Definitions Requirements Page Acrobat Reader
Income Guidelines 2013-2014 Income Guidelines 2009-2010, Acrobat Reader
Special Dietary Needs Form (Down Loadable Version) Special Dietary Needs Form, Acrobat Reader
Special Dietary Needs Form (On-Line Version) Acrobat Reader
W-9 Form W-9 Form, Word document

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New Hampshire Department of Education
101 Pleasant Street | Concord, NH | 03301-3494
Telephone: (603) 271-3494 | TDD Access: Relay NH 711