CACFP Host Site Application

Please fill out the form below to request the Afterschool ReFuel program for your site.

If you answer “yes” to the items below, please fill out the application to apply!

  • Do you provide school-aged children with enrichment programming outside of school hours?
  • Are you located in an area where the majority of students at the local school receive free or reduced meal benefits?
  • Are you a non-profit with proof of 501c3 status?
  • Do you have at least 30 children in attendance every day?
  • Do you have refrigeration for at least 2 days worth of meals?
  • Will you attend annual training at OFS?
  • Will you maintain daily compliance paperwork?

  • Site Information

  • Please list the person(s) who will be in charge of daily meal service, starting with the primary contact.
    NameTitleEmailPhone 
  • Do you have adequate refrigeration for the meals you will be serving each day and leftovers?

  • Program Information

  • Please list the Start and End Dates of your program:

  • Start Date:
    MM slash DD slash YYYY
  • End Date:
    MM slash DD slash YYYY
  • Example: 11am - 2pm
  • Example: "5-10"
  • By signing this form, you attest that all above information is true to the best of your knowledge.
  • MM slash DD slash YYYY