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All Program Forms

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Form Name	Form Number	Form Download	Form Download (Alternative Format)	Instructions Download	Program Name
Good Cause Transfer Request Form					CACFP - Adult Day Care
Micro-Purchase Log					CACFP - Adult Day Care
Small Purchase Log					CACFP - Adult Day Care
Excess Net Cash Resources Plan for CACFP/SFSP					CACFP - Adult Day Care
CACFP Serious Deficiency Process Notification Template Letters					CACFP - Adult Day Care
CACFP Serious Deficiency Process Notification Form					CACFP - Adult Day Care
Building for the Future - Black and White					CACFP - At-Risk Afterschool
Building for the Future - Color					CACFP - At-Risk Afterschool
CACFP - Centers Claim for Reimbursement - Site Level					CACFP - At-Risk Afterschool
CACFP Medical Statement Form					CACFP - At-Risk Afterschool
Child Nutrition Programs Waiver Request					CACFP - At-Risk Afterschool
Contracting Entity Request for Waiver of 15% Limit for Allowable Administrative Costs					CACFP - At-Risk Afterschool
F&N Complaint Form - English					CACFP - At-Risk Afterschool
F&N Complaint Form - Spanish					CACFP - At-Risk Afterschool
Gender Separation Exception Request Form					CACFP - At-Risk Afterschool
Permanent Agreement Between Sponsoring Organization and Child Care Site					CACFP - At-Risk Afterschool
Permanent Agreement Between Sponsoring Organization and Child Care Site - Sponsoring Organization Provides Meals/Snacks					CACFP - At-Risk Afterschool
Permanent Agreement Contracting Entity Specific Amendment - Name					CACFP - At-Risk Afterschool
Permanent Agreement Contracting Entity Specific Amendment - Programs					CACFP - At-Risk Afterschool
Pre-Award Civil Rights Compliance Review					CACFP - At-Risk Afterschool
Racial/Ethnic Participant Data Collection Prototype					CACFP - At-Risk Afterschool
Texas Department of Agriculture Food and Nutrition Division Permanent Agreement					CACFP - At-Risk Afterschool
Milk Flexibility for Emergency Conditions Notification					CACFP - At-Risk Afterschool
Good Cause Transfer Request Form					CACFP - At-Risk Afterschool
Micro-Purchase Log					CACFP - At-Risk Afterschool
Valid At-Risk Unaffiliated Site Questionnaire/Attestation					CACFP - At-Risk Afterschool
Small Purchase Log					CACFP - At-Risk Afterschool
Excess Net Cash Resources Plan for CACFP/SFSP					CACFP - At-Risk Afterschool
CACFP Serious Deficiency Process Notification Template Letters					CACFP - At-Risk Afterschool
CACFP Serious Deficiency Process Notification Form					CACFP - At-Risk Afterschool
Building for the Future - Black and White					CACFP - Child Care Center
Building for the Future - Color					CACFP - Child Care Center
CACFP - Centers Claim for Reimbursement - Site Level					CACFP - Child Care Center
CACFP Infant Feeding Preference					CACFP - Child Care Center
CACFP Meal Benefit Income Eligibility Form (Child Care)					CACFP - Child Care Center
CACFP Meal Benefit Income Eligibility Form (Child Care) in Spanish					CACFP - Child Care Center
CACFP Meal Benefit Income Eligibility Form Letter to Households (Child Care Centers)					CACFP - Child Care Center
CACFP Meal Benefit Income Eligibility Form Letter to Households (Child Care Centers) in Spanish					CACFP - Child Care Center
CACFP Medical Statement Form					CACFP - Child Care Center
Child Nutrition Programs Waiver Request					CACFP - Child Care Center
Contracting Entity Request for Waiver of 15% Limit for Allowable Administrative Costs					CACFP - Child Care Center
F&N Complaint Form - English					CACFP - Child Care Center
F&N Complaint Form - Spanish					CACFP - Child Care Center
Gender Separation Exception Request Form					CACFP - Child Care Center
Household Contact					CACFP - Child Care Center
Permanent Agreement Between Sponsoring Organization and Child Care Site					CACFP - Child Care Center
Permanent Agreement Between Sponsoring Organization and Child Care Site - Sponsoring Organization Provides Meals/Snacks					CACFP - Child Care Center
Permanent Agreement Contracting Entity Specific Amendment - Name					CACFP - Child Care Center
Permanent Agreement Contracting Entity Specific Amendment - Programs					CACFP - Child Care Center
Pre-Award Civil Rights Compliance Review					CACFP - Child Care Center

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Assistance available in English and Spanish. Please call 877-TEX-MEAL (877-839-6325) for help. Additional translations services available as well.

In accordance with federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, this institution is prohibited from discriminating on the basis of race, color, national origin, sex (including gender identity and sexual orientation), disability, age, or reprisal or retaliation for prior civil rights activity.

Program information may be made available in languages other than English. Persons with disabilities who require alternative means of communication to obtain program information (e.g., Braille, large print, audiotape, American Sign Language), should contact the responsible state or local agency that administers the program or USDA’s TARGET Center at (202) 720-2600 (voice and TTY) or contact USDA through the Federal Relay Service at (800) 877-8339.

To file a program discrimination complaint, a Complainant should complete a Form AD-3027, USDA Program Discrimination Complaint Form which can be obtained online at: https://www.usda.gov/sites/default/files/documents/ad-3027.pdf, from any USDA office, by calling (866) 632-9992, or by writing a letter addressed to USDA. The letter must contain the complainant’s name, address, telephone number, and a written description of the alleged discriminatory action in sufficient detail to inform the Assistant Secretary for Civil Rights (ASCR) about the nature and date of an alleged civil rights violation. The completed AD-3027 form or letter must be submitted to USDA by:

1. Mail:

U.S. Department of Agriculture
Office of the Assistant Secretary for Civil Rights
1400 Independence Avenue, SW
Washington, D.C. 20250-9410; or

2. Fax: (833) 256-1665 or (202) 690-7442; or

3. Email: program.intake@usda.gov.

This institution is an equal opportunity provider.