INTERESTED CLIENT QUESTIONNAIRE
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:
Submit
