This form must be reproduced and distributed annually to each participant’s household and used to classify each participant for free, reduced, and paid. NOTE: You must document enrollment information for each child enrolled at your institution; you may use the combined form or you may still use a separate enrollment form for each child.
This form is to be used to document your annual Civil Rights data collection. NOTE: This form does NOT need to be submitted to VDH; instead, keep the form on file at your institution with your CACFP records.
New Income Eligibility Guidelines for classifying each participant. These guidelines are effective July 1, 2012. NOTE: Participants classified on or after July 1, 2012 should be classified using these income guidelines.