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INTERESTED CLIENT QUESTIONNAIRE

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Name of Day Care:

CACFP Funding:

Site Address:

City:

Zip Code:

Contact Person:

Phone:

Email:

Web Site:

Implementation Time Frame:

No of days Service needed:

/Week ,

/Year

MEALS NEEDED

Breakfast

Lunch

Snacks

AfterSchool Prog.

Meal Count:

Breakfast

Lunch

Snacks

AfterSchool Prog.

Timing:

SERVING TIMINGS

Current Meals provider Company:

Any Current or past Challenges:

Kitchen & Storage facility/Refrigeration:

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