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2015-2016 SY Annual Agreement Renewal

**DEADLINES**

JUNE 1, 2015 - Deadline for SFAs to complete and submit the Free & Reduced School Meals Household Application and Verification forms packet to the State Agency for approval. 

JUNE 8, 2015 - Deadline for SFAs to complete all parts of the agreement renewal with all required hard copy documents received in the State Agency.  Please do not mail documents on June 8th; they must be in the State Agency office by that date.

Online Application

Instructions for completing On-line Application

Step-by-Step guidelines for the SFA to complete the online application to administer one or more of the School Nutrition Programs.

Three parts:  SFA Application, Site Application, Checklist (includes a listing of all hard copy documents that must be submitted to the State Agency).

Access the online renewal application at:  https://www.ncchildnutrition.org/

Complete the Site Application first and take note of the new certification box at the bottom of each site application page.

Food Safety Inspections must be completed in the online application (see "Applications" tab).


Written Agreement Documents

Document TitleDescription/PurposeSFA Action/Instructions

2015-16 Agreement and Free and Reduced Price Policy Statement

Traditional Public Trad. Public w/highlights

Charter SchoolsCharter w/highlights

RCCIs
RCCI w/highlights

NonPublic SchoolsNonPublic w/highlights

**NOTE** Agreements with highlighted changes are provided for FYI purposes ONLY.  Please DO NOT submit the highlighted version to the State Agency.

State Board of Education, North Carolina Department of Public Instruction Agreement to Administer the Federally Funded Child Nutrition Programs (also known as the Annual Written Agreement).

The Agreement outlines the terms between the State Agency (SA) and the LEA/SFA (Local Education Agency/School Food Authority) dictating requirements to administer one or more of the School Nutrition Program (SNP).

The Free and Reduced Price Policy Statement outlines officials designated to make eligibility determinations for the SNP. Furthermore it marks that the LEA/SFA will develop procedures to provide benefits to student.

NOTE:  This is a checklist item in the Online Application

ALL SFAs should print and maintain on file at the SFA along with the other 2015-16 Agreement Renewal documentation.

Agreement Signature Page

This document is indication by the LEA/SFA that all terms and conditions of the agreement and policy statement will be followed.

NOTE:  This is a checklist item in the Online Application

Must be completed by ALL SFAs.
  • Print THREE Signature pages. 
  • Obtain the appropriate signatures on each page in BLUE INK.
  • Submit all THREE (3) signature pages to the State Agency.   
  • Please do not submit copies of signature pages.  Each page must be signed in blue ink.
  • Required Signature(s): Superintendent, SN Administrator/Director and Finance Officer

Local Wellness Policy Responsibility Document & Signature Page

CLICK HERE to download the document.

Provides the contact name for the person responsible for the Local Wellness Policy and Outlines the terms that the LEA will develop and execute a plan to promote student wellness in an effort to prevent and reduce childhood obesity as they provide school meals that meet the minimum federal school meal standards.

NOTE:  This is a checklist item in the Online Application

  • Must be completed by ALL SFAs.
  • Print and submit ONE (1) copy with appropriate signature
  • Required Signature(s): 
Traditional:  Superintendent 
Charter:  Board Chair     
RCCI:  SN Director    
NonPublic: SN Director or Supt.

CLICK HERE to download the document.

Annual confirmation and an indication that all meals provided by the SFA to all students will meet current meal pattern requirements.

NOTE:  This is a checklist item in the Online Application

  • Must be completed by ALL SFAs.
  • Print and submit TWO (2) copies
  • Required Signature(s): SFA Administrator

CLICK HERE to download the document.

Identification by the LEA of the choice for implementing sale and service of competitive foods during the school day.

NOTE:  All SFAs are required to complete this document; however, it is not included as a checklist item in the SN Technology System. 

  • Must be completed by ALL SFAs
  • Select a Smart Snacks Option and submit ONE (1) copy to the state agency.
  • Required Signature(s):
Traditional - Superintendent
Charter - Board Chair
RCCI - SN Director
NonPublic - SN Director or Superintendent

Community Eligibility Provision (CEP) Agreement Amendment 

CLICK HERE to download the document.

**IMPORTANT NOTE** This document is only for SFAs participating in Community Eligibility Provision

Agreement amendment between the State Board of Education, North Carolina Department of Public Instruction and the LEA to operate the Community Eligibility Provision (CEP) (only if applicable) – Signature on this document demonstrates the LEA will be compliant with the CEP provision in the participating school(s).

  • Submit TWO (2) hard copies to state agency.
  • Required Signature(s):

Traditional:  Superintendent 
Charter:  Board Chair     
RCCI:  SN Director    
NonPublic: SN Director or Supt.

CLICK HERE to download the document.

Documents SFA's selected method of establishing the effective date of certification/eligibility for the F&RP School Meals Household Application; Date of Submission or Date of Eligibility
  • Select the appropriate Option (check box)
  • Obtain appropriate signature and submit ONE (1) copy
  • Required Signature(s):
SN Administrator

2015-2016 North Carolina Free & Reduced Price School Meals Household Application Template & Verification Forms

NC PROTOTYPE - Free & Reduced Price School Meals Household Application

F&R Priced Application and Verification Forms w/highlights

F&R Priced Application and Verification Forms for NON web-based applications

F&R Priced Application and Verification Forms for Web-based applications

**IMPORTANT NOTE**  Not applicable to SFAs that have implemented Community Eligibility Provision district wide.

Prototype documents used for determining student/household eligibility for school meals, notifying households of benefits, conducting verification, sharing Information, and notification of Direct Certification.  Year round schools should submit documents and info as soon as possible due to the short turnaround time.

IMPORTANT NOTE:  Year round schools should submit documents and info as soon as possible due to the short turnaround time.

Submission Deadline:  June 1, 2015

  • SFAs must submit their F&R App and Verification forms to the state agency for approval prior to distribution.
  • Submit this a F&R Application on SFA letterhead/or in the completed state as if it is ready to be distributed to households.


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