Arkedu.state.ar.us



___________________________________________________________________________________________

AGREEMENT

2001-2002 SCHOOL YEAR

BETWEEN SCHOOL FOOD AUTHORITY AND ARKANSAS DEPARTMENT OF EDUCATION

(National School Lunch, School Breakfast, Afterschool Snack, and Special Milk Programs)

___________________________________________________________________________________________

LEA Number____________________District____________________________County___________________

Superintendent_____________________Phone Number___________________Fax Number_________________

Mailing Address______________________________________________________________________________

______________________________________________________________________________

Nutrition Director________________________Phone Number______________Fax Number________________

Person Responsible for Claim___________________Phone Number______________Fax Number____________

| PROGRAM |REGULAR TERM Beginning And |NUMBER OF | SUMMER TERM|NUMBER OF SCHOOLS | CN |

| |Ending Dates |SCHOOLS |Beginning And Ending |PARTICI- |OFFICE USE |

| | |PARTICI- PATING |Dates |PATING |ONLY |

| National School | | | | | |

|Lunch | | | | | |

| School | | | | | |

|Breakfast | | | | | |

| Afterschool | | | | | |

|Snack | | | | | |

| *Special Milk | | | | | |

*Available only to schools not participating in school lunch, school breakfast, or afterschool snack programs.

INSTRUCTIONS: (1) COMPLETION OF AGREEMENT: AN ORIGINAL AND ONE COPY OF THIS AGREEMENT MUST BE COMPLETED AND SIGNED BY SUPERINTENDENT AND CHILD NUTRITION DIRECTOR. DEADLINE FOR SUBMISSION TO THE CHILD NUTRITION UNIT IS JUNE 15, 2001.

(2) MENU PLANNING OPTIONS: Review the assurances for each menu planning option. Select the option that will best meet local needs. The signature

of the District Child Nutrition Director is required on the menu planning option noted on Schedule A if a change is made.

(3) SCHEDULE A: Check the name and location of each school as reported to the

Child Nutrition Unit for 2000-01 SY. Make corrections and additions for SY 2001-2002 as needed.

(4) COMPLETE SCHEDULE A FOR AFTERSCHOOL SNACK PROGRAMS: Complete only for schools applying for afterschool snacks.

Notification for approval as area-eligible or non-area-eligible will be

included when signed 2001-2002 Agreement is returned.

(5) SCHOOL FOOD AUTHORITY=S (SFA) COPY: When this Agreement is approved, one of the originals will be returned for the files of the school food authority

In order to effectuate the purpose of: (1) the National School Lunch Act, as amended (42 U.S.C. 1751-1769), Afterschool Snack (PL 105-336, section 107-108), and regulations governing the National School Lunch Program (7 CFR Parts 210 and 245), and (2) the Child Nutrition Act of 1966, as amended (42 U.S.C. 1771-1790), and regulations governing the School Breakfast and Special Milk Programs, (7 CFR, Parts 220 and 215), the Arkansas Department of Education (herein-after referred to as AThe Department@) and the school food authority, whose name and address appear on page 1, acting on behalf of each school listed on Schedule A of this Agreement, covenant and agree as follows:

THE DEPARTMENT AGREES THAT, to the extent of funds available, it shall reimburse the school food authority in connection with meals or milk served to school children in the indicated program(s) in schools listed in Schedule A attached hereto, during the effective period of this Agreement. During any fiscal year, the amount of reimbursement paid to the school food authority for lunches and/or breakfasts served children in each school shall not exceed an amount equal to the number of reimbursable meals served to children, multiplied by the rates assigned by the Department.

In the Special Milk Program, (available only for schools without lunch, breakfast, or afterschool snacks and to students in split session kindergartens who do not have access to lunch or breakfast), (1) the rate of reimbursement per half pint of milk purchased for service to children other than needy children shall be the rate provided for in 215.8(b) and (2) within the limitations set forth in 215.8(c), the rate of reimbursement for milk purchased for service to needy children shall be equal to the cost (after discount). If milk is purchased at more than one price, the average cost shall be used.

THE SCHOOL FOOD AUTHORITY AGREES THAT it will conform to the following requirements in the conduct of all program(s):

1. “School food authority and participating schools under its jurisdiction, shall comply with all provisions of

7 CFR Parts 210, 215, 220 and 245 as applicable.”

2. “Maintain a nonprofit school food service and observe the limitations on the use of nonprofit school food

service revenues set forth in Sec. 210.14(a) and the limitations on any competitive school food service as set forth in Secs. 210.11(b) and 220.12" Ref. Secs. 210.9(b)(1), 215.7(d) and 220.7(e)(1).

3. “Limit its net cash resources to an amount that does not exceed three month=s average expenditures for its nonprofit school food service or such other amount as may be approved in accordance with Sec. 210.19(a)@

Ref. Secs. 210.9(b)(2) and 220.7(e)(1)(iv).

4. AMaintain a financial management system as prescribed under Secs. 210.14(c) and 220.13(I)@ Ref. Secs. 210.9(b)(3) and 220.7(e)(1).

5. “Comply with the requirements of The Department=s regulations regarding financial management

(7CFR 3016)@ Ref. Sec. 210.9(b)(4).

6. “Serve lunches, during the lunch period, which meet the minimum requirements prescribed in Sec. 210.10 or 210.10(a), whichever is applicable@ Ref. Sec. 210.9(b)(5). Also, “serve breakfasts which meet the minimum requirements prescribed in Sec. 220.8 or 220.8(a), whichever is applicable, during a period designated as the breakfast period by the school” Ref. Sec. 220.7(e)(2).

7. APrice the lunch and breakfast as a unit@ Ref. Sec. 210.9(b)(6) and 220.7(e)(3).

8. AServe lunches/breakfasts free or at a reduced price to all children who are determined by the school food

authority to be eligible for such meals under 7 CFR Part 245" Ref. Sec. 210.9(b)(7) and 220.7(e)(4).

9. AClaim reimbursement at the assigned rates only for reimbursable free, reduced price and paid lunches and breakfast to eligible children in accordance with 7 CFR Part 210, 220.7(2)(6). The school food authority official signing the claim shall be responsible for reviewing and analyzing meal counts to insure accuracy as specified in Sec. 210.8 governing claims for reimbursement. Failure to submit accurate claims will result in the recovery of an overclaim and may result in the withholding of payments, and/or suspension or termination of the program as specified in Sec. 210.25. If failure to submit accurate claims reflects embezzlement, willful misapplication of funds, theft, or fraudulent activity, the penalties specified in Sec. 210.26 shall apply” Ref. Sec. 210.9(b)(8).

10. ACount the number of free, reduced price and paid reimbursable meals served to eligible children at the point of service@ Ref. Sec. 210.9(b)(9).

11. ASubmit Claims for Reimbursement in accordance with Secs. 210.8, 215.10 and 220.11" Ref. Secs.

210.9(b)(10), 215.7(d)(5) and 220.7(e)(7).

12. AThe program applicant hereby agrees that it will comply with Title VI of the Civil Rights Act of 1964

(42 U.S.C. 2000d et seq.), Title IX of the Education Amendments 1972 (20 U.S.C. 1681 et seq.), Section

504 of the Rehabilitation Act 1973 (29 U.S.C. 794), the Age Discrimination Act of 1975 (42 U.S.C. 6101

et seq.), all provisions required by the implementing regulations of the Department of Agriculture, Department of Justice Enforcement Guidelines, 28 CFR 50.3 and 42, and Food and Nutrition Services (FNS) directives and guidelines, to the effect that, no person shall, on the grounds of race, color, national

origin, sex, age or disability, be excluded from participation in, be denied benefits of, or otherwise be subject to discrimination under any program or activity for which the program applicant receives federal financial assistance from FNS; and hereby gives assurance that it will immediately take measures necessary

to effectuate this agreement” (7 CFR parts 15, 15(a), 15(b).

13. ABy accepting this assurance, the program applicant agrees to compile data, maintain records and submit

reports, as required, to permit effective enforcement of the nondiscrimination laws and permit authorized

United States Department of Agriculture (USDA) personnel during normal working hours to review such records, books and accounts as needed to ascertain compliance with the nondiscrimination laws. If there are any violations of this assurance, the Department of Agriculture, FNS, shall have the right to seek judicial enforcement of this assurance. This assurance is binding on the program applicant and its successors, transferees and assignees, as long as they receive assistance or retain possession of any assistance from the Department. The person or persons whose signatures appear on this form are authorized to sign this assurance from The Department. The person or persons whose signatures appear on this form are authorized to sign this assurance on behalf of the program applicant” Ref. FNS Instruction 113.6, “Civil Rights Compliance and Enforcement in the School Nutrition Programs,” and Secs. 210.9(b)(11), 215.7(d)(3) and 220.7(e)(15).

14. AMake no discrimination against any child because of his or her eligibility for free or reduced price meals in

accordance with the approved Free and Reduced Price Policy Statement.@ Ref. Secs. 210.9(b)(12) and

220.7(e)(5).

15. AEnter into an agreement to receive donated foods as required by 7 CFR Part 250.@ Ref. Sec. 210.9(b)(13).

16. AMaintain, in the storage, preparation and service of food, proper sanitation and health standards in

conformance with all applicable State and local laws and regulations.@ Ref. Secs. 210.9(b)(14) and

220.7(e)(8).

17. AAccept and use, in as large quantities as may be efficiently utilized in its nonprofit school food service, such

foods as may be offered as a donation by the Department.@ Ref. Secs. 210.9(b)(15) and 220.7(e)(10).

18. AMaintain necessary facilities for storing, preparing and serving food.@ Ref. Secs. 210.9(b)(16) and 220.7(e)(11).

19. AUpon request, make all accounts and records pertaining to its school food service/milk program available to

the State agency and to FNS, for audit or review, at a reasonable time and place. Such records shall be

retained for a period of three years after the date of the final Claim for Reimbursement for the fiscal year to

which they pertain, except that if audit findings have not been resolved, the records shall be retained beyond

the three year period as long as required for resolution of the issue raised by the audit.@ Ref. Secs.

210.9(b)(17), 215.7(d)(7) and 220.7(e)(13).

20. AMaintain files of currently approved and denied free and reduced price applications respectively, and the

names of children approved for free lunch based on documentation certifying that the child is included in a

household approved to receive benefits under the food stamp program. If applications are maintained at the school food authority level, they shall be readily retrievable by school.@ Ref. Sec. 210.9(b)(18).

21. ARetain the individual applications for free and reduced price lunches/breakfasts/free milk/afterschool snacks submitted by families for a period of three years after the end of the fiscal year to which they pertain or as otherwise specified under paragraphs 210.9(b)(17), 215.7(d)(8) and 220.7(e)(14).”

22. Provide the State agency with a list of all elementary schools under its jurisdiction in which 50 percent or more of enrolled children have been determined eligible for free or reduced price meals as of October 1.” Ref 210.9(b)(20).

23. The program applicant hereby agrees that it will comply with the Drug-Free Workplace Act of 1988, Title V Subtitle D: and 7CFR Part 3017, Subpart F.

SPECIAL MILK PROGRAM

1. “If electing to provide free milk, (i) serve milk free to all eligible children at times that milk is made available to non-needy children under the Program, (ii) make no discrimination against any needy child

because of his inability to pay for the milk” Ref. Sec. 215.7(d)(2).

2. “Claim reimbursement only for milk as defined in Part 215 and in accordance with the provisions of

Secs. 215.8 and 215.10” Ref. Sec. 215.7(d)(4).

AFTERSCHOOL SNACK

(Applies Only if SFA intends to participate in Afterschool Snack Program

as indicated on Page 1 of this Agreement):

1. The Afterschool Snack Program(s) is operated only by a school(s) currently operating a National School Lunch

Program (NSLP) and will be available only to students that are 18 years old or under except that

reimbursement may be claimed for a student whose 19th birthday occurs during the school year. The federal afterschool snack program must be operated as part of the district food service programs as supervised by the district nutrition director.

2. The purpose of the program(s) is to provide care in an after school setting. The program(s) is organized

to provide children with regularly scheduled activities in a setting that is structured and supervised.

3. The program(s) includes education or enrichment activities in an organized, structured and supervised

environment. Extracurricular activities can only qualify if the basic purpose of the Afterschool Snack Program

is to provide after school care. Under no circumstance can organized athletic programs engaged in

interscholastic sports be approved as an Afterschool Snack Program.

4. Reimbursement will only be claimed for snacks served after the school day ends.

5. The maximum charge for a reduced price snack is $.15, 210.9 (c)(4).

6. Snacks claimed for reimbursement will meet the snack pattern for snacks as set forth in 7 CFR section

210.10(n) and 210.10a(j).

7. Price the meal supplement as a unit, 210.9(c)(2).

8. Serve meal supplements free or at a reduced price to all children who are determined by the school food authority to be eligible for free or reduced price meals under 7CFR part 245, 210.9(c)(6).

9. Claim reimbursement at the assigned rates only for meal supplements served in accordance with the

agreement, 210.9(c)(5).

10. Claim reimbursement for no more than one meal supplement per child per day, 210.9(c)(6).

11. Review each afterschool care program two times a year; the first review shall be made during the first four weeks that the school is in operation each school year, except that an afterschool care program operating year

round shall be reviewed during the first four weeks of its initial year of operation, once more during its first

year of operation, and twice each school year thereafter, 210.9(c)(7).

12. Comply with all requirements for claims for reimbursement (as required by Sec. 210.9(b)(8).

13. The following records are required and will be maintained to support the claim for reimbursement:

AREA ELIGIBLE: All snacks served free

* Documentation that verifies annually that 50% or greater of the enrolled students are certified eligible for free and reduced price meals or documentation to verify that the site is located in an attendance area of a school where at least 50% of the enrolled children are eligible for free or reduce price meals. The required ANNUAL documentation includes the attached form and the previous year’s applications for free and reduced price meals and/or the direct certification list.

* Daily count of total snacks served free to students.

* Production records that document the service of snacks that meet the snack pattern.

* Documentation of individual children=s attendance on a daily basis.

NON AREA ELIGIBLE: Snacks served at free, reduced price, and paid rates

* Documentation (current school year applications for free and reduced price meals and/or direct certification list) is required for all students served free or at a reduced price.

* Daily count of snacks served by category (free, reduced price, and paid).

* Production records that document the service of snacks that meet the snack pattern.

* Documentation of individual children=s attendance on a daily basis.

******************************** FOR ALL PROGRAMS ********************************

THE DEPARTMENT AND THE SCHOOL FOOD AUTHORITY MUTUALLY AGREE THAT:

1. The Policy Statement, Applications for Free and Reduced Price Meals and Schedule A, where applicable, are

parts of this Agreement.

2. Schools may be added or deleted from Schedule A, as need arises. Any change to Schedule A must be

approved by The Department.

3. The Department shall promptly notify the school food authority of any change in the minimum meal requirements or the assigned rates of reimbursement.

4. For the purpose of this Agreement, the following terms mean:

A. Adult: A person who is not a student of high school grade or under in a school as defined in 210.2

B. Meals: Food served at a school under the indicated program(s) which meets the applicable nutritional

requirements set forth in regulations. AMeals@ thus, mean breakfast, lunch, afterschool snack, or special milk, whichever is applicable.

C. Nonprofit Food Service: All food service operations conducted by the school food authority principally

for the benefit of school children, all revenue from which is used solely for the operation or improvement

of such food service. Ref. 210.2.

D. School: An educational unit of high school grade or under operating under public ownership in a single

building or complex of buildings. The term Ahigh school grade or under@ includes classes of pre-primary

grades, when they are recognized as a part of the educational system in the State (Ref. 210.2), or when they

are conducted in a school having classes of primary or higher grades, regardless of whether such pre-

primary classes are recognized as part of the educational system of the state.

E. School Food Authority: The governing body which is responsible for the administration of one or more

schools and which has the legal authority to operate lunch, breakfast or special milk programs therein.

Ref. 210.2.

5. This Agreement will be effective from July 1, 2001 through June 30, 2002 for days of operation specified on page 1 of Agreement. The Department may renew the Agreement for each school year, thereafter, by notice

in writing given to the school food authority.

6. This Agreement may be terminated upon ten days written notice on the part of either party hereto, and The

Department may terminate this Agreement immediately upon receipt of evidence that the terms and conditions

of this Agreement or any of the regulations have not been fully complied with by the school food authority.

Any termination of this Agreement by The Department shall be in accord with applicable laws and regulations.

7. The terms of this Agreement shall not be modified or changed in any way, other than with the consent in

writing of both parties hereto.

RECORD KEEPING REQUIREMENTS

The school food authority shall keep full and accurate records of the food service program(s). These records

serve as a basis for claims for reimbursement and for audit and review purposes. The records to be kept in each

program shall include the following:

1. Food Service (By Actual Count at Point of Service for Lunch, Breakfast and Afterschool Snack).

A. Daily number of meals served to children at full price

B. Daily number of meals served free to children

C. Daily number of meals served to children at reduced price

D. Daily number of half pints of milk served to paying children under the Special Milk Program

E. Daily number of half pints of milk served free to children under the Special Milk Program

2. Program Income (Receipts)

A. From opening cash balance

B. From Federal reimbursement

C. From reimbursable student meals

D. From adult meals

E. From a la carte sales

F. From contract meals

G. From loans to program

H. From all other sources, (i.e. Pouring Rights Contracts, interest, etc.

3. Program Expenditures

A. For food

B. For labor

C. For loan repayment

D. For other expenditures

4. Program Account Balance

A. Reconcile account balance with bank balance on a monthly basis

5. Value of Donations to Programs

A. Donated foods, exclusive of foods donated by the USDA

B. Donated services

C. All donations other than food and services

6. Program Management

A. Cycle menus and production records for lunches and breakfasts

B. Nutrient analysis and Child Nutrition (CN) labels or product analysis for all pre-prepared products

C. Standardized recipes

D. USDA commodity records

E. Free and reduced price meal applications and/or documentation of direct certification

F. Hearings on free lunch eligibility

G. Documentation of student and parent involvement

H. Record of compliance with procurement regulations

I. Documentation required on verification of eligibility

J. Edit checks

K. On-site reviews if school food authority operated more than one school

L. AGREEMENT between SFA and Arkansas Department of Education and the Policy Statement for

Free and Reduced Price Meals

M. Audit reports and written responses

N. Civil Rights complaints and resolutions

O. Claim for Reimbursement

SY 2001-2002 SCHOOL FOOD AUTHORITY AGREEMENT

I have received the Agreement for the 2001-2002 School Years between the School Food Authority and the Arkansas Department of Education and understand the provisions thereof.

____________________________________, Superintendent _______________________________

Signature Date

____________________________________, _______________________, ___________________________

(Person authorized to sign for Supt.) Title Date

____________________________________, Child Nutrition Director _____________________________

Signature Date

Claims cannot be paid without the signature of the superintendent or another person authorized to sign the claim. If a change in personnel is made at any time, submit a letter with the new authorized signature(s).

Arkansas Department of Education Approval

Child Nutrition Unit Use Only

Approved by:

___________________________________, Director, Child Nutrition Unit _____________________________

Date

MENU PLANNING OPTIONS

Each school food authority may select the menu planning option(s) that will best meet local needs. Different options may be used in different schools and different options may be used for breakfast and lunch in the same school. A brief list of assurances has been developed for each option to assist you in making your selection.

ASSURANCES:

Option I: Enhanced Food Based Menu Planning (FBMP) Approach

1. Cycle menus will be planned to meet requirements of the new USDA meal pattern for appropriate grade/age

groups and will be identified for school(s) in which they will be used. The cycle menu may allow changes for

seasons, holidays, availability of commodities, special events within the school or community, etc.

2. Standardized recipes will be used with preference given to recipes with nutrient analyses provided by USDA

or other appropriate sources.

3. Nutrient analyses CN label or formulation statement will be obtained and kept on file for all pre-prepared products in the menu cycle.

4. The above items will be made available to The Department staff who will perform menu nutrient analyses as part of the official review.

5. Training and monitoring of staff in each school will be provided to ensure that menus, purchases and recipes

are followed as planned.

6. Students will be taught the “offer vs. serve” provisions in schools where offer vs. serve is an option, and careful monitoring will ensure their understanding and compliance.

7. Training and monitoring of staff, including cashiers, in each school will be provided to ensure that menus, purchases, recipes, production procedures and new offer vs. serve provisions are followed.

Option II: Nutrient Standard Menu Planning (NSMP) Approach

1. Qualified personnel with adequate time are available to plan menus and implement the NSMP.

2. Personnel have attended or will attend state training on NSMP prior to implementation.

3. Hardware and software needs have been assessed, those found to meet the school food authority=s needs and

USDA requirements have been installed, and personnel have had adequate time to become proficient in

their use.

4. Cycle menus will be planned to meet nutrient standards established for appropriate grade/age groups and

identified for the school(s) in which they will be used. The cycle menu may allow changes for seasons,.

holidays, availability of commodities, special events within the school or community, etc.

5. Only standardized recipes and food specifications in the database will be used. Preference will be given to

recipes with nutrient analyses provided by USDA or other appropriate sources. If recipes, other than those

in the database are used, all ingredients in the recipe will be entered in the database.

6. Nutrient analyses for all pre-prepared products in the menu cycle that are not in the database of USDA

approved software will be obtained and added to the database.

7. The above items will be made available to ADE CN reviewers who will assess the accuracy of the use of the

NSMP system.

8. Students will be taught the “offer vs. serve” provisions in schools where offer vs. serve is an option, and careful monitoring will ensure their understanding and compliance.

9. Training and monitoring of staff, including cashiers, in each school will be provided to ensure that menus,

purchases, recipes, production procedures and new offer vs. serve provisions are followed.

Option III: Assisted Nutrient Standard Menu Planning (Assisted NSMP) Approach

1. Only menus, standardized recipes and food product specifications selected by the planner of the Assisted

NSMP cycle(s) will be used.

2. The proposed menu cycle(s) with standardized recipes, food product specifications, nutrient analyses of

products not in the USDA database, and nutrient analyses of the menu cycle(s) for appropriate grade/age

groups will be submitted to the ADE CN Unit for approval a minimum of eight (8) weeks prior to the date it is

expected to be used. Depending on the number of school food authorities choosing this option, the ADE CN

Unit may require up to four (4) weeks to approve or define problem areas.

3. Students will be taught the offer vs. serve provision of the NSMP system in schools where it is an option and

careful monitoring will ensure their understanding and compliance.

4. Training and monitoring of staff, including cashiers, will be provided in each school to ensure that menus,

purchases, recipes, and production procedures are followed as planned by the Assisted NSMP planner, and

that offer vs. serve provisions are implemented correctly.

5. If the weighting waiver is not requested, the nutrient analyses of the menu cycles will be reassessed by the

production and the frequency of menu offerings. If the waiver is requested and simple averaging is used, the

revision and reassessment of the menu cycle will be required only if participation has declined or the menu is

revised. Participation records prior to and during service of the first menu cycle will be assessed by the school

food authority to determine if this revision and reassessment by the menu planner is necessary.

6. Records will be retained and made available to ADE CN reviewers who will determine if the Assisted NSMP

system was correctly implemented.

7. The school food authority accepts the final responsibility for ensuring that nutrient standards are met.

Option IV: Traditional Meal Patterns Approach

1. Cycle menus will be planned to meet requirements of this meal pattern(s). The cycle menu may allow changes

for seasons, holidays, availability of commodities, special events within the school and community, etc.

2. Standardized recipes will be used with preference given to recipes with nutrient analyses provided by USDA or other appropriate sources.

3. Nutrient analyses will be obtained and kept on file for all pre-prepared products in the menu cycle(s).

4. The above items will be made available to the ADE CN staff who will perform menu nutrient analyses as

part of the official review.

5. Students will be taught the “offer vs. serve” provisions in schools where offer vs. serve is an option, and careful monitoring will ensure their understanding and compliance.

6. Training and monitoring of staff, including cashiers, in each school will be provided to ensure that menus, purchases, recipes, production procedures and new offer vs. serve provisions are followed.

Option V: Alternate Menu Planning Approach

School food authorities may modify one of the established menu planning approaches within the guidelines established. If interested in this option please contact your area specialist.

Public law 149, signed by the President on May 29, 1996, allows schools to use this meal pattern without doing nutrient analyses of menus. It does not delete the requirement to comply with nutrition standards established in the June 13, 1995 regulations. Careful planning and consistent use of sound procurement and preparation practices will be required to assure that these standards are met. Such practices may include adding fruits/vegetables and grains/breads beyond the minimum requirements as well as setting limits on the fat content in entrees and desserts.

_________________________________ ____________________

(District) (LEA Number)

SCHEDULE A SY 2001-2002

for

AFTERSCHOOL SNACK PROGRAMS

Complete the following form Only for schools within the district that will participate in the Afterschool Snack Program.

| | | | | | | |

|Col. A |Col. B |Col. C |Col. D |Col. E |Col. F |Col. G |

| | | | |(C + D) |(E ( B) | |

|School(s) |ENROLL-MENT |FREE ELIGIBLES |REDUCED |TOTAL FREE & |% OF FREE & REDUCED |SCHOOLS WITH 50% STUDENTS ELIGIBLE FOR FREE OR REDUCED PRICE |

| |AS OF OCT.1,2000 |AS OF OCT.1,2000 |ELIGIBLES |REDUCED |ELIGIBLES OF |MEALS OR SCHOOL LOCATED IN AN ATTENDANCE AREA WITH 50% OR |

| | | |AS OF OCT.1,2000|ELIGIBLES |ENROLLMENT |GREATER OF THE STUDENTS ELIGIBLE FOR FREE AND REDUCED PRICE |

| | | | | | |MEALS |

| | | | | | | |

| | | | | | |Yes No |

| | | | | | |(AREA ELIGIBLE) (NON-AREA ELIGIBLE) |

| | | | | | | | |

| | | | | | | | |

| | | | | | | | |

| | | | | | | | |

| | | | | | | | |

| | | | | | | | |

| | | | | | | | |

| | | | | | | | |

| | | | | | | | |

| | | | | | | | |

______________________________________ __________________________________

District Child Nutrition Director Superintendent

__________________ _____________________

Date Date

Attention: Afterschool Snack Programs

Districts With Afterschool Snacks in the 2001-02 School Year

Renewal Agreement Instructions For After Schoolsnack Programs to Update Schedule A :

In order to continue participating in the Afterschool Snack Program each year, the district must submit the data and calculations to determine the level of reimbursement (AREA ELIGIBLE OR NON-AREA ELIGIBLE) for each school.

Please fill out the form on the back of this sheet. After the calculations are made to determine AREA ELIGIBLE OR NON- AREA ELIGIBLE Schools, please:

1) Change the printed school district Schedule A data form to reflect any changes for these schools.

2) Be sure to mark the Schedule A form to ADD schools that have not previously participated in the program and to to to DELETE schools no longer participating.

3) Return two copies of this form with the two copies of the revised Schedule A form for School Year 2001-02.

FORM INSTRUCTIONS:

Column A: List all schools within your district that will participate in the Afterschool Snack Program for SY 2001-02.

Column B: List the October 1, 2000 enrollment for each school in which Afterschool Snacks will be served as reported to

the Child Nutrition Unit, ADE.

Column C: List the number of students eligible for free meals for each school in which Afterschool Snacks will be served as listed

on the October 1, 2000, report to the Child Nutrition Unit.

Column D: List the number of students eligible for reduced price meals for each school in which Afterschool Snacks will be served

as listed on the October 1, 2000, report to the Child Nutrition Unit.

Column E: Add the number of students eligible for free and reduced price meals.

Column F: Divide the total number of students eligible for free and reduced price meals in Column E by the enrollment as

listed in each school in Column B.

Column G: Use the percentage in Column F to indicate "yes" if the school meets the requirement as an AREA ELIGIBLE School for

free snacks (50% of enrollment must be certified eligible for free or reduced price meals). If the school is not eligible for

all free snacks indicate "no". These are considered NON-AREA ELIGIBLE Schools and snacks will be claimed at the free, reduced price, and paid rates.

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