Johnny Key

Commissioner of Education

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A Division of the Arkansas Department of Education

Forms

Afterschool Snack Program

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

Renewal of Agreement - School Year 2019-2020 

Complete Packet of all Agreement & Policy Statement forms (A-U) (PDF)

Renewal Agreement Checklist (PDF fillable)  

Instructions on How to Complete Renewal Agreement Packet (WORD)

Renewal of Agreement (PDF fillable)

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

Menu Planning Attestation (PDF fillable)

Food Safety Plan Attestation (PDF)

Health Inspection Statement (PDF)

Procurement Policy & Procedures (PDF)
 
Wellness Attestation (PDF)
 
Civil Rights Assurances & Attestation (PDF)
 
Attestation Statements – On-line Claims, Professional Standards (PDF)
 
Policy Statement 2019-2020 (PDF)
 
Meal Count and Collection Procedures (PDF)
 
Pre-K Meal Service (PDF)
 
Free and Reduced Price Meal Application Materials (PDF)
 
Method Used by School District for Distribution of Meal Applications (PDF)
 
SFA Election to use Date Flexibility (PDF)
 
CN Contact Information and Appeals Hearing Attestation (PDF) (form not needed for P2 non-base year and CEP)
 
Web-based Meal Application (PDF)
 
Schedule B – Afterschool Snack Program (PDF) (optional)

Schedule C-20 (PDF) Seamless Summer Option (optionaRenewal of Policy Statement – School Year 2018-2019

Forms & Letters - School Year 2019-2020

Frequently Asked Questions About Free and Reduced Price School Meals (WORD)
 
How to Apply (WORD)
 
2019-2020 Application for Free and Reduced Price School Meals (PDF)
 
Press Releases 
  1. CEP Public Release (WORD)
  2. P2 Base Year Public Release (WORD)
  3. P2 Non-Base Year Public Release (WORD)
  4. Non Provision (WORD)
Eligibility and Verification Letters (WORD)  return only if you are using forms other than the CNU sample forms
 
CEP Letter to the Household (WORD)
 
Income Eligibility Guidelines for School Year 2019-2020 (WORD) do not return
 
Safety Net School Districts for School Year 2019-2020 (WORD) do not return
 
 
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

Fruit and Vegetable Program

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

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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