National School Lunch Sponsor Training Child Nutrition Program (CNP) Sponsor Application

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1 National School Lunch Sponsor Training Child Nutrition Program (CNP) Sponsor Application Child Nutrition Program (CNP) Sponsor Application... 1 CNP System... 1 Online Application Process... 2 Sponsor Type... 2 Mailing Address... 2 Street Address... 2 Food Service Director... 2 Reimbursement Claims Official... 3 Procurement... 3 Racial/Ethnic Make Up... 4 On-site Reviews... 4 Direct Certification... 5 Eligibility Information... 5 RCCIs... 7 Edit Checks... 8 Meal Prices... 8 Estimated Student Enrollment... 9 FSMC... 9 Vendor/Caterer/FSMC Vendors/Caterers Certification SAVE Errors Sponsor Application CNP System User Authorization Form: Submit Completed Form If you forget your password contact Michelle Armstrong at , or by at michelle.armstrong@fldoe.org. If you have a change in staff or need modifications made to your user accounts, fill out a user authorization form and submit it to your Program Area Representative.

2 Online Application Process Sponsor Application Site Application Checklist Sponsor Type Section A - Sponsor Type A1. Indicate the type of education agency (Choose One): A. Public School District B. Private Nonprofit School C. Charter School D. Public Residential Child Care Institution(RCCI) E. Private Residential Child Care Institution(RCCI) F. Private Residential Child Care Institution(RCCI) and Private School G. Public Residential Child Care Institution(RCCI) and Private School H. Other Specify The type of sponsorship you choose dictates which questions will need to be answered and if additional checklist items will be required. Mailing Address Mailing Address A2. Address 1: A3. Address 2: A4. City: County: State: Zip: Note: All correspondence will be sent to the mailing address. Street Address Street Address Check this box if the street address is the same as the mailing address A5. Address 1: A6. Address 2: A7. City: County: State: Zip: Note: All correspondence will be sent to the mailing address. Food Service Director Remember: Continue to update as needed.

3 Food Service Director / Manager Title First Name Last Name A8. Name: A9. A10. Position: A11. Phone: Ext: Suncom: Fax: The food service director must be employed by the sponsor and cannot be an employee of a food service management company (FSMC) or a Business Management Company Reimbursement Claims Official Remember: Continue to update as needed. Reimbursement Claims Official Same as Food Service Director / Manager Title First Name Last Name A12. Name: A13. A14. Position: A15. Phone: Ext: Suncom: Fax: Procurement Procurement / Code of Conduct A16. Will the prototype Procurement Policy Statement provided by FNM be used? Yes No If no, submit a copy of the policy to FNM for approval prior to use. A17. Will the prototype Code of Conduct provided by FNM be used? Yes No If no, submit a copy of the policy to FNM for approval prior to use. Private Sponsors and Charter Schools Contact: David Whetstone david.whetstone@fldoe.org Public Sponsors Contact: Richard Menendez richard.menendez@fldoe.org Procurement Policy Specialist Christie Meresse

4 Racial/Ethnic Make Up The And Justice for All poster must be displayed in the meal service area where children can see it. Racial / Ethnic Make Up A18. Will the prototype Complaint of Discrimination form provided by FNM be used? Yes No If no, submit a copy of the form to FNM for approval prior to use. A19. Will the prototype Civil Rights Compliance worksheet provided by FNM be used? Yes No If no, submit a copy of the worksheet to FNM for approval prior to use. A20. Racial/ethnic make up percentage of this program s service area: White, Non-Hispanic Black, Non-Hispanic Hispanic Asian or Pacific Islander American Indian or Alaskan Native Multiracial Note: Only count students in this area. Percentage must equal 100 percent. On-site Reviews DOCUMENT On-site reviews must be conducted by school food authority (SFA) and not by an FSMC. On-Site Reviews (Sponsors with more than one site) A21. A. Will the prototype NSLP On-Site Review Form provided by FNM be used? Yes No N/A If no, submit a copy of the form to FNM for approval prior to use. B. Will the prototype ASSP On-Site Review Forms provided by FNM be used? Yes No N/A If no, submit a copy of the form to FNM for approval prior to use. Notes: NSLP - More than one site On-site review for each site must be conducted prior to February 1st of each school year. Afterschool Snack Program - all sites must conduct two reviews.

5 Deficiencies Corrective action Follow up within 45 days 7 CFR Direct Certification Direct Certification A22. A. Will Direct Certification be utilized? Yes No N/A B. If yes, will the prototype Direct Certification Eligibility Notification Letter provided by FNM be used? Yes No N/A If no, submit a copy of the letter to FNM for approval prior to use. Eligibility Information DOCUMENT Residential Child Care Institutes (RCCIs) check N/A for A23-A26. Eligibility Information A23. A. Will the prototype Application for Free and Reduced Price Meals provided by FNM be used? Yes No N/A If no, submit a copy of the application to FNM for approval prior to use. B. The most current Income Eligibility Guidelines must be used for eligibility determination. Yes No N/A A24. Will the prototype Application Instructions provided by FNM be used? Yes No N/A If no, submit a copy of the instructions to FNM for approval prior to use. A25. Will the prototype Letter to Parent provided by FNM be used? Yes No N/A If no, submit a copy of the letter to FNM for approval prior to use. A26. Will the prototype Notification of Eligibility Letter provided by FNM be used? Yes No N/A If no, submit a copy of the letter to FNM for approval prior to use. Notes for Question A27: RCCIs check N/A for A27A. This is where the apps are approved and not where the apps are maintained. Must enter the Official s Title (not their name). RCCIs Complete A27 B.

6 A27. A. Applications for Free & Reduced Price Meals are approved at: Central Office School Level N/A Other: Please explain below Notes on Question A28: Must Choose Family. RCCIs check N/A for A28-A29. A28. Applications for Free & Reduced Price Meals are: Individual Child Family N/A Verification must be complete by November 15th. DOCUMENT Notes on Question A29: RCCIs choose N/A for A29A A29F Select Focused for Question 29B. Select Yes for Questions 29C, D and E. A29. A. Verification is completed at: Central Office School Level N/A Other: Please explain below B. Which type of Verification is utilized? Focused Random N/A Note: Random verification requires prior approval. C. Will the prototype Verification Plan provided by FNM be used? Yes No N/A If no, submit a copy of the plan to FNM for approval prior to use. D. Will the prototype Selection Notification Letter provided by FNM be used? Yes No N/A If no, submit a copy of the letter to FNM for approval prior to use. E. Will the prototype Change of Benefit Letter provided by FNM be used? Yes No N/A If no, submit a copy of the letter to FNM for approval prior to use. F. Verification Official for Free/Reduced Price Applications Note: Verification Official(s) must be a Sponsor employee, not a FSMC employee, and must be different than the Hearing Official. Title: Phone: Note: Verification Official cannot be the same as the Hearing Official. Enter Job Title, not Individual s Name.

7 RCCIs check N/A for A30-A31. A30. Is computer software used for application approval? Yes No N/A If yes, indicate name of software: School-Link Technologies WinSNAP A31. Will the prototype Public Release provided by FNM be used? Yes No N/A RCCIs Schools check N/A for A32-A34. Residential Child Care Institution (RCCI) only A32. What is the student population type? Residential N/A Residential and day students B. Approving Official for Free/Reduced Price Applications or Determining Official for Individual Determination Forms Note: Approving Official(s) must be a Sponsor employee, not a FSMC employee, and must be different than the Hearing Official. Title: Phone: C. Hearing Official for Free/Reduced Price Applications Note: Hearing Official(s) may not be connected to the application or verification processes and may not be a FSMC employee. Title: Phone: A33. What documentation is used to qualify residential students for free meals? Individual Determination Form N/A Other, please describe: A34. A. Will the prototype Individual Determination Form provided by FNM be used? Yes No N/A If no, submit a copy of the form to FNM for approval prior to use. B. The most current Income Eligibility Guidelines will be used for eligibility determination. Yes No N/A Note: Must use prototype. DOCUMENT Schools check N/A for A35. If no day students, choose N/A.

8 The RCCI must validate each client s income annually, on July 1st of each year. A35. What documentation is used to qualify day students for free and reduced price meals? Free and Reduced application N/A Only claim paid meals reimbursement for day students Other, please describe below: Edit Checks Edit checks must be conducted by SFA and not by an FSMC. All sponsors must conduct edit checks. Must use prototype, select Yes. Edit Checks A36. Will the prototype Edit Check Worksheet provided by FNM be used? Yes No If no, submit a copy of the worksheet to FNM for approval prior to use. Compare each school s daily counts of free, reduced-price, and paid lunches to the number of children in that school currently eligible for free, reduced-price, and paid lunches, respectively, times an attendance factor. Meal Prices Reduced-price snack cannot be more than $.15. Reduced-price breakfast cannot be more than $.30. Reduced-price lunch cannot be more than $.40. Meal Prices A37. Are any of the sites pricing programs? If Yes, please complete the Meal Prices below. Yes No Meal Type Elementary Paid Middle Paid High Paid Reduced-Price Adults Price Breakfast Lunch Afterschool Snack If no adult meal prices, are adults charged a la carte prices?

9 Lunch Yes No N/A Breakfast Yes No N/A AfterSchool Snack Yes No N/A A38. Is the price charged for adult meals greater than or equal to the free reimbursement plus the value commodities? Yes No N/A A39. If no, does the SFA use general funds to support adult prices? Yes No N/A Estimated Student Enrollment October 1st update this section based on number of applications approved. Do not leave any box blank use 0 if none. Estimated Student Enrollment A40. Lunch Breakfast Snack A. Paying full sale price B. Paying reduced sale price C. Served Free A41. Attendance Factor percentage Notes on Question A41: This relates to block A36. Schools - attendance factor (AF) is 93.6%. RCCIs - AF is 100%. FSMC Food Service Management Company A42. Will Meals be purchased from another SFA? Yes No If Yes, please provide name of SFA: A43. Will the school nutrition program be operated/managed by a Food Service Management Company (FSMC)? Yes No If Yes - complete questions A44 and A45. If No - go to question A46. A44. Full Name of FSMC (or select Other): If Other is selected, forward a completed copy of the contract to FNM for approval. A45. Date Original Contract was Signed: Initial Year of Contract: First Year Renewal:

10 Second Year Renewal: Third Year Renewal: Fourth Year Renewal: If select Other, contact our office. In the initial year of the contract, these blocks must be completed. Vendor/Caterer/FSMC Private Sponsors and Charter Schools Contact: David Whetstone Public Sponsors Contact: Richard Menendez Procurement Policy Specialist Christie Meresse Vendors/Caterers If select Other, contact our office. A46. Will meals be purchased from a caterer or restaurant? Yes No If Yes - Select from this list: If Other is selected, please describe: A47. Is the school food service operated by a business management company? Yes No If Yes, please provide name of company: Education Service Provider - Select Yes for #A47. Certification Must check #A48- #A49. Sponsor Certification A48. I hereby certify that neither this SFA nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any Federal department or agency.

11 A49. I certify that the information on this application form is true and correct to the best of my knowledge. I understand that this information is being given in connection with receipt of federal funds; Department officials may, for cause, verify information; and the deliberate misrepresentation will subject me to prosecution under applicable federal and state criminal statutes. The SFA hereby agrees to comply with all state and federal laws and regulations governing Child Nutrition Programs. The person signing below will ensure that all monthly claims for reimbursement represent meals/milk served by category and that records are available to support these claims. It is acknowledged that once signed and when approved by the Florida Department of Education, this application places in force the permanent agreement effective with the current program year start date and any subsequent addendum for the current program year. A50. Authorized Signature: Date: A51. A. Does the school/institution expend or expect to expend a total of $500,000 or more in federal funds from any source this year? Yes No B. If yes, has a current audit been filed with FNM? Yes No Send certified mail to: FLDOE FNM Christie Meresse 325 West Gaines Street, Ste Tallahassee, FL or Fax to SAVE Screen shot displaying the save button.: Click Save. Errors Screen shot displaying error messages: Samples of Error Messages 1000 Sponsor Type is required Mailing Address is required Street Address is required Food Service Director / Manager title, first, last name, and phone are required Reimbursement Claims Official title, first, last name, and phone are required Yes or No must be selected for 'Will the prototype Procurement Policy Stmt. be used?' Yes or No must be selected for 'Will the prototype Code of Conduct be used?' Yes or No must be selected for 'Will the prototype Complaint of Discrimination form be used?'.

12 1009 Yes or No must be selected for 'Will the prototype Civil Rights Compliance worksheet be used?' Racial/Ethnic enrollment total must be %. To fix errors, click on Sponsor Applications. No errors, click on Finish and Back. Sponsor Application Screen shot showing that status of the sponsor application: Status should say Pending Submission. Currently no site applications have been added. After site applications are added, this error message will disappear.

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