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National School Lunch Program Application Materials


All forms have been changed. Last year's documents will not be accepted.

Forms that must be returned to the State Office
2014-2105 National School Lunch Program Attachments
NSLP Application Checklist Checklist Acrobat Reader
Attachment A - National School Lunch Program Attestation Form Attachment A Word document
Attachment B - Parent Letter for Free and Reduced Price Family Meals Application for Lunch and Breakfast Attachment B Word document
Attachment B-1 - Free and Reduced Price Family Meals Application for Lunch and Breakfast Attachment
B-1
Word document
Attachment C - Parent Letter and Special Milk Application (If applicable) Attachment C Word document
Attachment C-1 - Special Milk Application (if applicable) Attachment
C-1
Word document
Attachment D - After School Snack Program Application (If applicable) Attachment D Word document
Attachment E - State of NH Federal Meals Program Wellness Documentation Attachment E Word document
Attachment F - Ethnic/Racial Data Form (completed by RCCI's and Non-Public Schools only) Attachment F Word document
Attachment G - List of Board Members (completed by RCCI's and Non-Public Schools only) Attachment G Word document
Attachment H - Procurement and Food Service Management Compancy Declaration Issue Attachment H Word document
Attachment J - Computerized System for Verifying Free and Reduced-Price Family Meals Applications Attachment J Word document
Attachment K - NSLP Paid Lunch Equity (PLE) Attestation Attachment K Word document

Attachment K-1 -NSLP Paid Lunch Equity (PLE) Tool - (completed excel worksheets) used to calculate Paid Lunch prices [NEW]

Attachment
K-1
Excel
Attachment T - Non Program Food Revenue Calculator Tool (completed excel worksheets) used to complete non-program food revenue [NEW] Attachment T Excel
Parent Appeal Rights Parent Appeal Word document
Forms for School Food Authority Use
Attachment L - Procurement Procedures Declaration Page Attachment L Word document
Attachment M - Notification of Eligibility Determination Attachment M Word document
Attachment N - Sharing of Information with Other Programs Attachment N Word document
Attachment O - Free and Reduced Price Family Meals Family Application/Eligibility Disclosure Requirement Programs (In-House Document for SAU's) Attachment O Word document
Attachment P - Determining Official Income Guidelines Attachment P Acrobat Reader
Attachment R - Administrative Appeal Procedures Attachment R Acrobat Reader
Attachment S - Notice of Direct Certification Attachment S Word document

Income GuidelinesRates for Reimbursement
FY 2015
(7/01/14 - 06/30/15)
Acrobat Reader FY 2015
(7/01/14 - 6/30/15)
Acrobat Reader
FY 2014
(7/01/13 - 6/30/14)
Acrobat Reader FY 2014
(7/01/13 - 6/30/14)
Acrobat Reader

FY 2013
(7/01/12 - 6/30/13)

Acrobat Reader FY 2013
(7/01/12 - 6/30/13)
Acrobat Reader

Microsoft Excel Symbol Microsoft Excel format. You can download a free reader from Microsoft.

Acrobat Reader Symbol Acrobat Reader format. You can download a free reader from Adobe.

Microsoft Word Symbol Microsoft Word format. You can download a free reader from Microsoft.


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