Johnny Key

Commissioner of Education

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Forms

Afterschool Snack Program

Afterschool Snack Program Review From/On-Site Review Form (PDF)

Renewal of Agreement - School Year 2018-2019 

Renewal Agreement Checklist (PDF fillable)  

Instructions on How to Complete Renewal Agreement Packet (PDF)

Renewal of Agreement (PDF fillable)

Schedule A (blank) (PDF fillable) only return if new school(s)

Menu Planning Attestation (PDF fillable)

Meal Patterns (PDF) - do not return to CNU

Health Inspection Report for 2017-2018 School Year (PDF fillable)

Contracts with FSMC, Vendors, Consultants (PDF fillable)

Wellness Attestation (PDF fillable)

Civil Rights Assurances Attestation (PDF fillable)

Attestation Statements Paid Lunch Equity, Claims, Professional Standards (PDF fillable)

Schedule B Afterschool Snack (PDF fillable) - only return if SFA is serving Afterschool Snacks

Schedule C-19 Seamless Summer Option Summer 2019 (PDF fillable) - only return if SFA is serving Seamless Summer in summer of 2019

Renewal of Policy Statement – School Year 2018-2019

Instructions for the Renewal of the Policy Statement (WORD)

Renewal of Policy Statement - School Year 2018-2019 (PDF fillable)

Meal Count and Collection Procedures (PDF fillable)

Pre-K Meal Service (PDF fillable)

Free and Reduced Price Meal Application Materials, Forms, and Letters Attestation Statement (WORD/EXCEL)

Distribution of Free and Reduced Price Meal Applications – Methods Used (WORD/EXCEL)

Child Nutrition Contact Information and Appeals Hearing Attestation (WORD/EXCEL) (if entire SFA/LEA is non-base year Provision 2 or Community Eligibility do not send this form)

Information that MUST be on Free and Reduced Price Meal Application Materials (WORD/EXCEL)

Frequently Asked Questions About Free and Reduced Price School Meals – update with district specific information (WORD)

How to Apply – update with district specific information (WORD)

2018-2019 Application for Free and Reduced Price School Meals – update with district specific information (PDF)

Public Release – update with district specific information (WORD)

Letters for Eligibility and Verification – update with district specific information (WORD)

Income Eligibility Guidelines for School Year 2018-2019 (WORD)

Safety Net School Districts for School Year 2018-2019 (WORD) - do not return to CNU

On-Line Meal Application Addendum SY 2018-2019 (PDF)

The USDA Translated Applications website includes translation resources available for use by School Districts.

The Spanish language application and letters are included on this USDA website.

Translations for applications intended to be used directly by SFAs to distribute to families:

·        http://www.fns.usda.gov/school-meals/translated-applications

Community Eligibility Provision (CEP) – Policy Statement Documents

CEP Letters to Households School Year 2018-19 (WORD)

CEP Public Release School Year 2018-19 (WORD)

CEP Schedule B-19 – Afterschool Snack (WORD)

CEP Schedule C-19 – Seamless Summer (WORD)

Provision 2 – Policy Statement Documents

P2 Base Year Public Release School Year 2018-19 (WORD)

P2 Non-Base Year Public Release School Year 2018-19 (WORD)

Fruit and Vegetable Program

  • FFVP Claim for Reimbursement 2018-19 (9/2018) (EXCEL)
  • Instructions for 2018-19 FFVP Claim for Reimbursement (9/2018) (PDF)
  • 2018-19 Equipment Request Form (WORD)
  • FFVP On-Site Review Form (EXCEL)
  • Hourly Pay Rate Form (PDF)
  • Monthly Time Sheet (EXCEL)
  • 2018-19 Operational Plan (EXCEL)
  • 2018-19 FFVP Deadlines (PDF)

Healthy Schools / Wellness Policy

  • Wellness Committee Requirements Checklist - Part 1 and 2 of Triennial Assessment (WORD)

Labor Evaluation

  • Meals Per Labor Hour Worksheet SY 2017-18 (9/2017) (EXCEL)
  • Sample Staffing Guidelines using Meals per Labor Hour from Iowa Dept. of Ed. 9/27/06) (PDF)

Procurement

  • Buy American Justification Form (WORD)
  • Bid Tabulation Form – (8/2009) (EXCEL)

Program Management

  • Short and Long Week Meal Pattern Calculation Guide (PDF)
  • Food Donation Documentation (PDF)
  • How You Can Help Prevent Wasted Food (PDF)
  • Lunch Menu Planning Tool (beginning SY 12-13) – Developed by the Iowa Department of Education, Nutrition Services) (EXCEL)
  • Master Roster Less than 1000 Students (EXCEL)
  • Master Roster More than 1000 Students (EXCEL)
  • Recipe Form (PDF)
  • Recipe Analysis Worksheet (EXCEL)
  • Lunch Production Record - with Temperature Control Record Instructions (EXCEL)
  • Lunch Production Record - K-08 (EXCEL)
  • Lunch Production Record - 09-12 (EXCEL)
  • Lunch Production Record Instructions (PDF)
  • Daily Breakfast Production Record - with Temperature Control Record (8/2014) (PDF)
  • Weekly Afterschool Snack Production Record  - with Temperature Control Record (PDF)
  • On Site Review (2017) (PDF)
  • Afterschool Snack Program On-Site Review Form (PDF)

Reimbursement

  • Flowchart for Original Claim Submission (PDF)
  • Flowchart for Claim Revision Processing (PDF)
  • Claim Revision Request Form (PDF)
  • Aid for Efficient On-Line Claim Preparation (EXCEL)
  • Instruction for Aid for Efficient On-Line Claim Preparation (PDF)
  • Cash Management Worksheet (EXCEL)
  • Daily Record Form (EXCEL)
  • Edit Check 2 Worksheet (PDF)

Meal Modifications (previously Special Dietary Needs)

Staff Training

  • Documentation of Child Nutrition Training for Staff – Sign In Sheet (PDF)
  • Consolidation of Training Hours (PDF)

Summer Meals Program

  • Seamless Summer On-Site Review Form for SFA’s (WORD)
  • Schedule C-18 Seamless Summer Option Summer 2018 (PDF fillable) - only return if SFA is serving Seamless Summer in summer of 2018

Time Certification

  • Time Certification Form - 100% Child Nutrition (PDF)
  • Time Certification Form - Less Than 100% Child Nutrition (EXCEL)

Verification Reporting

  • FNS-742-SFA Verification Collection Report (EXCEL)
  • Districts Required Preform Verification Using Standard Sample Method - SY 2018-19 (EXCEL)
  • Districts to Preform Verification Using Standard Sample Method (by default) - SY 2018-19 (EXCEL)
  • Districts Approved to Preform Verification Using Alternate 2 Method - SY 2018-19 (EXCEL)
  • Districts Approved to Preform Verification Using Alternate 1 Method - SY 2018-19 (EXCEL)

State Standards

Learn more about the standards that define the knowledge and skills Arkansas students should have in order to be ready for college and careers.

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Licensure & Certification

Find critical information about renewing Arkansas educator licenses, adding areas of licensure, licensing by reciprocity from other states, background checks and more.

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ESSA

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MY SCHOOL INFO

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