2008-2009 Child Nutrition Program
Renewal Documents for Sponsors in ONLY the Special Milk Program

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 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:  Special Milk Program Announcement
Form 3G - PDF Form 3G - MS Word --- Form 3G:  Change of Authorized Representative
Form 3I - PDF Form 3I - MS Word --- Form 3I:  Special Milk - Letter, Instructions and Application
Form 7A - PDF Form 7A - MS Word --- Form 7A:  Letter to Household about Direct Certification
Form 8M - PDF Form 8M - MS Word --- Form 8M:  Letter to Household about Benefit Decrease
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

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.