2008-2009 Child Nutrition Program
School Nutrition Program Renewal Documents

Renewal forms that require the sponsor to enter information are available as Microsoft Word forms.  To use a form, first download it to your computer's hard drive as follows:
1 - Right-click on the hyperlink (i.e. bullet).
2 - Select "Save Target As" and specify the location on your hard drive where the file will be saved, then click "Save".
3 - Once you have downloaded the file, open it in Word.  Key information into the gray boxes and print out the form.

(a)

(b)


(c)


Title/Description
Program Renewal Memo - PDF --- --- Program Renewal Memo
Program Renewal Document Checklist - PDF Program Renewal Document Checklist - MS Word --- Program Renewal Checklist:  IMPORTANT!  Print, complete and return with the Program Agreement Addendums and any other documents that are mailed to KSDE.
Program Agreement Addendum - PDF Program Agreement - MS Word --- Program Agreement Addendum
KN-CLAIM Quick Reference for Applications - PDF --- --- KN-CLAIM Quick Reference for the Sponsor & Site Applications
KN-CLAIM Quick Reference for Wellness Policy Builder - PDF --- --- KN-CLAIM Quick Reference for the Wellness Policy Builder
Instructions for Program Renewal - PDF --- --- Program Renewal Instructions for Forms 3C through 8M
Form 3C - PDF Form 3C - MS Word Form 3C - MS Word Form 3C:  Meals - Letter, Instructions and Application
Click here for information about the two MS Word versions of Form 3C.
Form 3D - PDF Form 3D - MS Word --- Form 3D:  Notification of Eligibility Determination
Form 3E - PDF Form 3E - MS Word --- Form 3E:  Waiver of Confidentiality
Form 3F - PDF Form 3F - MS Word --- Form 3F:  Announcement of Child Nutrition Programs
Form 3G - PDF Form 3G - MS Word --- Form 3G:  Change of Authorized Representative
Form 3J - PDF Form 3J - MS Word --- Form 3J:  Special Milk - Information for Households with Pre-K and Kindergarten Students
(for sponsors providing both school meals AND the Special Milk Program with paid and free milk)
Form 7A - PDF Form 7A - MS Word --- Form 7A:  Letter to Household about Direct Certification
Form 8D - PDF Form 8D - MS Word --- Form 8D:  Letter to Household about Selection for Verification
Form 8M - PDF Form 8M - MS Word --- Form 8M:  Letter to Household about Benefit Decrease
At-Risk Application - PDF --- --- Optional Application for State At-Risk Funds
New Site Application - PDF New Site Application - MS Word --- New Site Application - Complete this form to initiate participation of a new site.
Guidance

Title/Description
Guidelines for Determining Eligibility - PDF --- --- Guidelines for Determining Eligibility
Income Eligibility Guidelines - PDF --- --- Income Eligibility Guidelines Chart
Instructions Regarding Confidentiality - PDF --- --- Instructions Regarding Confidentiality of Reduced Price/Free Eligibility Information
Foreign Language Materials --- --- Foreign Language Materials Information
After School Care Snack Program - PDF --- --- After School Care Snack Program, Questions & Answers
Special Assistance Provisions - PDF --- --- Special Assistance Alternatives (i.e. Provisions 1, 2 and 3)
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Annual Financial Status Summary - Excel

Annual Financial Status Summary - These forms can be used as worksheets prior to entering the data online in KN-CLAIM (due by August 15).  Complete the monthly financial worksheets and the annual totals will be automatically computed.
Annual Financial Status Summary Instructions for Public Schools - PDF --- --- Annual Financial Status Summary Instructions for Public Schools
Annual Financial Status Summary Instructions for Nonpublic Schools - PDF --- --- Annual Financial Status Summary Instructions for Private Schools, RCCIs and State-Operated Schools

Keep a copy of all program renewal documents for your files.
Signed documents must contain ORIGINAL signatures.
All program documents are due by July 15, 2008 to:
Child Nutrition & Wellness, Kansas State Department of Education,
120 SE 10th Ave., Topeka, KS 66612-1182.
Questions? Call (785) 296-2276.