2005-2006 Program Forms
The forms on this page will not be valid for the 2006-2007 school year. Please check back for updates on the new forms.
Step 1: Obtaining Direct Certification Match Results
No program forms required. Please directly certify children on CNP WEB
Step 2: Requesting Eligibility Information
| Form Name |
Format |
| 2005-2006 Reimbursement Rates |
PDF |
Word |
| Media Release |
PDF |
Word |
| Civil Rights Compliance |
PDF |
Word |
| CNP Web User Agreement |
PDF |
Word |
| CNP Web/Common Logon Change or Delete Form |
PDF |
Word |
| Multi-use Application for free and reduced-price meals 2005-2006 (English) |
PDF |
Word |
| Multi-use Application for free and reduced-price meals 2005-2006 (Spanish) |
PDF |
Word |
| Agreement between Local Education Agency and AHCCS (KidsCare) regarding identification of children |
PDF |
|
| Application for free and reduced-price meals (English) |
PDF |
Word |
| Application for free and reduced-price meals (Spanish) |
PDF |
Word |
| Parent Letter, 2005-2006 (English) Revised |
PDF |
Word |
| Parent Letter, 2005-2006 (Spanish) Revised |
PDF |
Word |
| Parent Letter Non-Pricing 2005-2006 (English) |
PDF |
Word |
| Parent Letter Non-Pricing 2005-2006 (Spanish) |
PDF |
Word |
| Special Milk Letter, pricing, No applications (English) |
PDF |
Word |
| Special Milk Letter, pricing, No applications (Spanish) |
PDF |
Word |
| Special Milk, Letter to Parents, Applications 2005-2006 (English) Revised |
PDF |
Word |
| Special Milk, Letter to Parents, Applications 2005-2006 (Spanish) Revised |
PDF |
Word |
| Medicaid/Kidscare Sharing Form 2005-2006 (English) |
PDF |
Word |
| Medicaid/Kidscare Sharing Form 2005-2006 (Spanish) |
PDF |
Word |
| Kidscare Screener 2005-2006 (English) |
PDF |
Word |
| Kidscare Screener 2005-2006 (Spanish) |
PDF |
Word |
Step 3: Certifying Income Eligible Children
| Form Name |
Format |
| 2005-2006 Income Guidelines |
PDF |
Word |
| Notification letter, School Meals (English) |
PDF |
Word |
| Notification letter, School Meals (Spanish) |
PDF |
Word |
| Notification letter, milk, pricing 2005-2006(English) |
PDF |
Word |
| Notification letter, milk, pricing 2005-2006 (Spanish) |
PDF |
Word |
| Notification of Temporary Approval Expiring (English) |
PDF |
Word |
| Notification of Temporary Approval Expiring (Spanish) |
PDF |
Word |
Step 4:Verifying Income Applications
| Form Name |
Format |
| Verification Report To Be Completed on |
CNP WEB |
| Notification of Verification (English) Revised |
PDF |
Word |
| Notification of Verification (Spanish) |
PDF |
Word |
| Notification of Adverse Action (English) |
PDF |
Word |
| Notification of Adverse Action (Spanish) |
PDF |
Word |
| 2005-2006 Error-Prone Worksheet |
PDF |
|
Production Records
| Form Name |
Format |
| Production Record - Traditional |
PDF |
| Production Record - Enhanced |
PDF |
|
| Production Record - NuMenus/Assisted NuMenus |
PDF |
|
| Production Record - Snack |
PDF |
|
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Contact Information
National School Lunch Program & School Breakfast Program
Arizona Department of Education
1535 West Jefferson Street, Bin 7
Phoenix, Arizona 85007
Tel: (602) 542-8700
Toll Free: (800) 352-4558
Fax: (602) 542-3818 or (602) 542-1531
Mary Szafranski, MPH, RD, SFNS (602) 542-8704
Mary.Szafranski@azed.gov
Civil Rights
