Overview
School Nutrition Programs | Manuals | Program Guidance | Resources | Nutrition Education
The forms below are for the U.S. Department of Agriculture's (USDA) school nutrition programs, including the School Breakfast Program (SBP), National School Lunch Program (NSLP), Seamless Summer Option (SSO) of the NSLP, Afterschool Snack Program (ASP) of the NSLP, Fresh Fruit and Vegetable Program (FFVP), and Special Milk Program (SMP). For guidance on program requirements, visit the CSDE's Program Guidance for School Nutrition Programs webpage.
Note: The date in italics after each document is the most current revision date.
A B C D E F G H I J K L M N O P Q R S T U V W X Y Z
A
Action Planning
- Action Planning Form July 2019
- Addenda (Free and Reduced Applications)
- Addendum A: Sharing Information with Other Programs (English) June 2020
- Addendum A: Sharing Information with Other Programs (Spanish) June 2020
- Addendum B: Healthcare for Uninsured Kids and Youth (HUSKY) (English) June 2020
- Addendum B: Healthcare for Uninsured Kids and Youth (HUSKY) (Spanish) June 2020
- Addendum C: Information on the Supplemental Nutrition Assistance Program (SNAP) (English) October 2020
- Addendum C: Information on the Supplemental Nutrition Assistance Program (SNAP) (Spanish) November 2020
Administrative Review
- Menu Documentation Organizational Tool (MDOT) January 2020
- Sample Administrative Review Organizational Tool (AROT) January 2020
- Sample Administrative Review Organizational Tool (AROT) for Residential Child Care Institutions (RCCIs) and 100 Percent Community Eligibility (CEP) Districts January 2020
Afterschool Snack Program (ASP)
- ASP Daily Attendance and Snack Count Record for Schools that are not Site/Area Eligible September 2020
- ASP Daily Snack Count Record for Grades K-12 in Site/Area Eligible Schools September 2020
- ASP Daily Snack Count Record for Preschoolers in Site/Area Eligible Schools September 2020
- ASP Daily Snack Count and Production Record for Grades K-12 in Site/Area Eligible Schools September 2020
- ASP Daily Snack Count and Production Record for Preschoolers in Site/Area Eligible Schools September 2020
- ASP Monthly Attendance and Snack Count Record for Schools that are not Site/Area Eligible September 2020
- ASP Monthly Attendance and Snack Count Record in Site/Area Eligible Schools September 2020
- ASP On-site Monitoring Form September 2020
- ASP Production Record for Ages 1-2 September 2020
- ASP Production Record for Ages 3-4 September 2020
- Sample Completed ASP Production Record for Ages 3-4 September 2020
- ASP Production Record for Grades K-12 September 2020
- Sample Completed ASP Production Record for Grades K-12 September 2020
- ASP School Eligibility Checklist September 2020
Authorized Signatures
- Authorized Signatures Change Form August 2019
- Authorized Signatures Change Form Instructions August 2019
C
Certification of Meal Pattern Compliance
Civil Rights
Community Eligibility Provision (CEP)
- CEP Monthly Federal Reimbursement Estimator (USDA)
- CEP Participation Worksheet June 2020
- CEP Sample Parent Notification Letter (English) July 2019
- CEP Sample Parent Notification Letter (Spanish) August 2019
Connecticut Nutrition Standards (CNS)
- CNS Worksheet 1: Evaluating Snacks for Compliance with the Connecticut Nutrition Standards November 2019
- CNS Worksheet 2: Evaluating Yogurt and Pudding for Compliance with the Connecticut Nutrition Standards November 2019
- CNS Worksheet 3: Evaluating Smoothies for Compliance with the Connecticut Nutrition Standards November 2019
- CNS Worksheet 4: Evaluating Fruits and Vegetables for Compliance with the Connecticut Nutrition Standards November 2019
- CNS Worksheet 5: Evaluating Soups for Compliance with the Connecticut Nutrition Standards November 2019
- CNS Worksheet 6: Evaluating Cooked Grains for Compliance with the Connecticut Nutrition Standards November 2019
- CNS Worksheet 7: Evaluating Entrees Sold Only A La Carte for Compliance with the Connecticut Nutrition Standards November 2019
- CNS Worksheet 8: Evaluating Non-entree Combination Foods for Compliance with the Connecticut Nutrition Standards November 2019
- CNS Worksheet 9: Nutrient Analysis of Recipes November 2019
- CNS Worksheet 10: Evaluating Recipes for Sugars November 2019
D
Disclosure Release
- Disclosure Release Request for Free or Reduced Eligibility Status August 2019
- USDA Memo SP 16-2016, CACFP 06-2016, SFSP 10-2016: Disclosure Requirements for the Child Nutrition Programs December 2015
District Benefit Issuance
- District Benefit Issuance Excel Spreadsheet (DBIES) February 2018
E
Edit Check Forms
- CEP Edit Check Worksheet and Instructions February 2018
- CEP Participation Worksheet April 2019
- Edit Check Worksheet for Lunch November 2018
- Instructions for Edit Check Worksheet for Lunch August 2019
- Edit Check Worksheet for Breakfast and Lunch May 2019
Equipment
- Equipment Purchase Approval Request Form August 2019
- Equipment Purchase Capital Expenditure Approved List for School Food Authorities August 2019
- Equipment Purchase Prior Approval Process for School Food Authorities August 2019
Exemption Requests
- Lunch Period Waiver: Circular Letter C-9: Federal and State Requirements for Provision and Timeframe of Daily Lunch Period for Students November 2000
- Meal Pattern Exception Request Form for Residential Child Care Institutions (RCCIs) August 2019
- Weekend or Vacation Waiver: FNS 786-7 Rev. 2: Reimbursement for Meals and Milk Served on Weekends November 2010
F
Food Distribution Program (see USDA Foods)
Food Safety
- Alternate QFO Statement August 2019
- Food Service Employee Training Record for Sanitation and Food Safety August 2019
- On-site Training Record for Sanitation and Food Safety August 2019
- Qualified Food Operator (QFO) Responsibilities for Connecticut Child Nutrition Programs August 2019
- Refrigerator and Freezer Temperature Control Record August 2019
Food Service Management Company
- Exhibit I: Sample School Food Authority (SFA)/Food Service Management Company (FSMC) Monitoring Form September 2019
Free and Reduced-price Meals
-
Family Application
- Application for Free and Reduced-price School Meals or Free Milk (English) June 2020
- Application for Free and Reduced-price School Meals or Free Milk (Spanish) June 2020
- Sample Parent/Guardian Letter: Frequently Asked Questions About Free and Reduced-price School Meals (English) June 2020
- Sample Parent/Guardian Letter: Frequently Asked Questions About Free and Reduced-price School Meals (Spanish) June 2020
- Sample Parent/Guardian Letter: Frequently Asked Questions About Free School Milk (English) June 2020
- Sample Parent/Guardian Letter: Frequently Asked Questions About Free School Milk (Spanish) June 2020
- Foreign Language Translations for Free and Reduced-price Application Forms (USDA webpage)
-
Parent/Guardian Notification Letter
- Sample Parent/Guardian Letter: Notification of Change in Free Eligibility Due to a Transfer from a CEP School to a Non-CEP School (English) June 2020
- Sample Parent/Guardian Letter: Notification of Change in Free Eligibility Due to a Transfer from a CEP School to a Non-CEP School (Spanish) June 2020
- Sample Parent/Guardian Notification Letter (English) June 2020
- Sample Parent/Guardian Notification Letter (Spanish) June 2020
- Sample Parent/Guardian Notification Letters for Direct Certification
- Version 1: SNAP, TFA, Medicaid (English) June 2020
- Version 1: SNAP, TFA, Medicaid (Spanish) June 2020
- Version 2: Foster Child, Homeless, Runaway, Head Start (English) June 2020
- Version 2: Foster Child, Homeless, Runaway, Head Start (Spanish) June 2020
- Version 3: Medicaid Benefits Reduced-price Meals (English) June 2020
- Version 3: Medicaid Benefits Reduced-price Meals (Spanish) June 2020
H
Healthy Food Certification (HFC)
- HFC Documentation Form 1: Purchased Foods and Beverages Sold in Cafeteria September 2019
- HFC Documentation Form 2: School-made Foods Sold in Cafeteria September 2019
- HFC Documentation Form 3: Foods and Beverages Sold in Vending Machines September 2019
- HFC Documentation Form 4: Foods and Beverages Sold in School Stores September 2019
- HFC Documentation Form 5: Food and Beverage Fundraisers September 2019
- HFC Documentation Form 6: Foods and Beverages Sold from Other Sources September 2019
- HFC Documentation Form 7: School-made Foods Sold from Other Sources September 2019
- Sample Fundraiser Form for HFC January 2019
I
Interschool Agreements
- Full-service Interschool Agreement Form January 2020
- Recipient Site Vended Interschool Agreement January 2020
M
Meal Counting and Claiming
- Meal Application and Data Management Process Form August 2020
- Site Information on Money Collection and Point-of-Service (POS) Meal Count Systems Form August 2020
Media Release (see Public Media Release)
Medical Statement
- Medical Statement for Meal Modifications in School Nutrition Programs (English) July 2019
- Medical Statement for Meal Modifications in School Nutrition Programs (Spanish) August 2019
- Guidance and Instructions: Medical Statement for Meal Modifications in School Nutrition Programs (English) July 2019
- Guidance and Instructions: Medical Statement for Meal Modifications in School Nutrition Programs (Spanish) August 2019
Menu Forms for Preschoolers
- Breakfast Five-day Menu Planning Form for Ages 1-2 December 2020
- Breakfast Five-day Menu Planning Form for Ages 3-4 December 2020
- Breakfast Four-day Menu Planning Form for Ages 1-2 December 2020
- Breakfast Four-day Menu Planning Form for Ages 3-4 December 2020
- Breakfast Seven-day Menu Planning Form for Ages 1-2 December 2020
- Breakfast Seven-day Menu Planning Form for Ages 3-4 December 2020
- Lunch Five-day Menu Planning Form for Ages 1-2 December 2020
- Lunch Five-day Menu Planning Form for Ages 3-4 December 2020
- Lunch Four-day Menu Planning Form for Ages 1-2 December 2020
- Lunch Four-day Menu Planning Form for Ages 3-4 December 2020
- Lunch Seven-day Menu Planning Form for Ages 1-2 December 2020
- Lunch Seven-day Menu Planning Form for Ages 3-4 December 2020
Menu Planning Checklists for Lunch for Grades K-12
- Five-day Week Lunch Menu Planning Checklist: Grades K-5 December 2020
- Five-day Week Lunch Menu Planning Checklist: Grades 6-8 December 2020
- Five-day Week Lunch Menu Planning Checklist: Grades 9-12 December 2020
- Five-day Week Lunch Menu Planning Checklist:Grades K-8 December 2020
- Seven-day Week Lunch Menu Planning Checklist:Grades 6-8 December 2020
- Seven-day Week Lunch Menu Planning Checklist: Grades K-5 December 2020
- Seven-day Week Lunch Menu Planning Checklist: Grades 9-12 December 2020
- Seven-day Week Lunch Menu Planning Checklist: Grades K-8 December 2020
Monitoring Forms
- On-site School Review Checklist for the NSLP August 2019
- On-site School Review Checklist for the SBP August 2019
- Overview of Meal Counting and Claiming Process August 2020
- Seamless Summer Option (SSO) Sponsor Monitor Site Review Form December 2020
Nonprogram Foods
- Nonprogram Pricing Worksheet: Adult Meals August 2019
- Nonprogram Pricing Worksheet: A La Carte Sales August 2019
- Nonprogram Revenue Calculator (USDA) February 2019
- Nonprogram Revenue Tool for Five-day Reference Period (Kansas Department of Education) 2018
P
Paid Lunch Equity
- Paid Lunch Equity Calculations and Tool 2020-21 (USDA) March 2020
- Paid Lunch Equity Guidance: USDA Memo SP 07-2020: Paid Lunch Equity: Guidance for School Year 2020-21 January 2020
Policy Statement
- Policy Statement for Free and Reduced-price Meals, Afterschool Snack Programs, and Free Milk June 2020
Press Release (see Public Media Release)
Procurement
- Buy American Justification Form August 2019
- Certification Regarding Debarment, Suspension, Ineligibility, and Voluntary Exclusion – Lower Tier Covered Transactions September 2019
- Sample Code of Conduct for Procurement September 2019
- Sample Procurement Procedures for School Food Authorities (Version 1) September 2019
- Sample Procurement Procedures for School Food Authorities (Version 2) September 2019
Production Records
Food Components Lunch or Breakfast
- Production Record for Grades K-5 in the NSLP or SBP January 2020
- Production Record for Grades 6-8 in the NSLP or SBP January 2020
- Production Record for Grades 9-12 in the NSLP or SBP January 2020
- Production Record for Grades K-8 in the NSLP or SBP (Legal size) January 2020
- Production Record for Grades K-12 in the NSLP or SBP (Legal size) January 2020
- Production Record for Preschool (Ages 3-4) and Grades K-8 in the NSLP or SBP (Legal size) January 2020
- Production Record for Preschool (Ages 3-4) and Grades K-12 in the NSLP or SBP (Legal size) January 2020
- Production Record for Ages 1-4 (Preschool) in the NSLP or SBP January 2020
- Production Record for Ages 3-4 (Preschool) in the NSLP or SBP January 2020
Food Items Lunch
- Production Record for Grades K-5 in the NSLP January 2020
- Production Record for Grades 6-8 in the NSLP January 2020
- Production Record for Grades 9-12 in the NSLP January 2020
- Production Record for Grades K-8 in the NSLP (Legal size) January 2020
- Production Record for Grades K-12 in the NSLP (Legal size) January 2020
- Production Record for Preschool (Ages 3-4) and Grades K-8 in the NSLP (Legal size) January 2020
- Production Record for Preschool (Ages 3-4) and Grades K-12 in the NSLP (Legal size) January 2020
- Production Record for Ages 1-4 (Preschool) in the NSLP January 2020
- Production Record for Ages 3-4 (Preschool) in the NSLP January 2020
Food Items Breakfast
- Production Record for Grades K-5 in the SBP January 2020
- Production Record for Grades 6-8 in the SBP January 2020
- Production Record for Grades 9-12 in the SBP January 2020
- Production Record for Grades K-8 in the SBP (Legal size) January 2020
- Production Record for Grades K-12 in the SBP (Legal size) January 2020
- Production Record for Preschool (Ages 3-4) and Grades K-8 in the SBP (Legal size) January 2020
- Production Record for Preschool (Ages 3-4) and Grades K-12 in the SBP (Legal size) January 20200
- Production Record for Ages 1-4 (Preschool) in the SBP January 2020
- Production Record for Ages 3-4 (Preschool) in the SBP January 2020
Professional Standards
- Professional Standards Tracking Log January 2020
Public Media Release
S
Seamless Summer Option (SSO)
- SSO Daily Meal Count Form October 2020
- SSO Monitor Site Review Form December 2020
- SSO Sample Press Release December 2020
- SSO Sponsor Pre-operational Review Form December 2020
Special Milk Program
- SMP Daily Milk Count Form (EXCEL) August 2019
- SMP Daily Milk Count Form (PDF) August 2019
- SMP Daily Milk Count Form Instructions August 2019
- Sample Completed SMP Daily Milk Count Form August 2019
Standardized Recipes
U
USDA Foods
- USDA Foods Transfer Request Form August 2019
- Worksheet for Calculating Direct Delivery of USDA Foods (Brown Box) February 2019
- Worksheet for Calculating Processed USDA Foods February 2019
V
Verification
- Letter of Verification Results and Adverse Action for Income Households (English) August 2020
- Letter of Verification Results and Adverse Action for Income Households (Spanish) August 2020
- Household Letter to Verify Eligibility (English) August 2020
- Household Letter to Verify Eligibility (Spanish) August 2020
- Household Letter: Second Notification to Verify Eligibility (English) August 2020
- Household Letter: Second Notification to Verify Eligibility (Spanish) August 2020
- Household Employer Letter (English) August 2020
- Household Employer Letter (Spanish) August 2020
- Household Letter for Social Security Office (English) August 2020
- Household Letter for Social Security Office (Spanish) August 2020
- Optional Household Letter: Notification of Continuation of Benefits as a Result of Verification (English) August 2020
- Optional Household Letter: Notification of Continuation of Benefits as a Result of Verification (Spanish) August 2020
- Sample Verification Selection Worksheet August 2020
Y
Yield Study
- Yield Study Form for Child Nutrition Programs (CSDE) June 2020