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Get Cacfp Eligibility Application Children Enrolled In ...

Child s Name: Last First M.I. Date of Birth Provider s Name: PART 2A - HOUSEHOLDS NOW GETTING FOOD STAMPS, TANF/WORK FIRST, FDPIR, NATIONAL SCHOOL LUNCH OR WIC BENEFITS: Complete this part and sign the statement in PART 3 - DO NOT complete PART 2B. If a child or a child s parent is participating in or subsidized under a Federally or State supported child care or other benefit program with an income eligibility limit that does not exceed the.

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