CACFP Host Site Application

Please fill out the form below to request the afterschool meal program for your site.
  • Site Information

  • Please list the person(s) who will be in charge of daily meal service, starting with the primary contact.
    NameTitleEmailPhone 
    Add a new row
  • Do you have adequate refrigeration for the meals you will be serving each day and leftovers?
  • Program Information

  • Please list the Start and End Dates of your program:

  • Start Date:
  • End Date:
  • Example: 11am - 2pm
  • Example: "5-10"
  • By signing this form, you attest that all above information is true to the best of your knowledge.