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Child & Adult Care Food Program

Meal Benefit Forms: English

Meal Benefit Income Eligibility Form (pdf.) (complete packet) (doc.)

List of items in the packet:
- Instructions for Centers and Sponsors (pdf.) (doc.)
- Letter to Households:
    Tier II Day Care Homes & Child Care Center (pdf.) (doc.)
    Adult Day Care (pdf.) (doc.)
- Letter to Provider (Tier I or Provider's Own Children) (pdf.) (doc.)
- Instructions for Completing Meal Benefit Form (pdf.) (doc.)
- Meal Benefit Income Eligibility Form (pdf.) (doc.)
- Sharing Information with Medicaid/SCHIP (pdf.) (doc.)
- Notification of Selection for Verification of Eligibility (pdf.) (doc.)
- Letter of Verification Results (pdf.) (doc.)
 

  Prototype forms and letters for sponsoring organizations and independent centers .doc .pdf
  Instructions for sponsoring organizations and independent centers .doc .pdf
  Meal benefit form for child care .doc .pdf
  Instructions for filling out the meal benefit form for child care .doc .pdf
  Letter to child care center households .doc .pdf
  Results of verification for child care households .doc .pdf
  Request disclosure for Medicaid or SCHIP .doc .pdf
  Request verification from child care households .doc .pdf
  Letter to day care home households .doc .pdf
  Letter for tier I reimbursement .doc .pdf
    .doc .pdf
    .doc .pdf
   
Pamphlet for Potential Providers
Building for the Future - Flier
Building for the Future - Brochure
Building for the Future - Poster


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