1 20 17.doc - CACFP Weekly Meal Adjustment Request Form...

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CACFP Weekly Meal Adjustment Request Form COMPLETED Forms are due by end of day Friday Monitor’s Name: Katie Johnson Week of: 1/16-1/20/17 Supervisor’s Initials: Bookkeeping Initials: Jermaine Allen Date of FR/FUV Date of Meal Adjustment Type of Visit (FR/ FUV) Site Name Site # Meal Type # of Meals Delivered 1 st Meals 2 nd Meals # of Meals Carried over Discards Total Meals Served Disallowed Meals Code 1/17/17 Na FR Tree House Enrichment Center 12833 SN 10 20 Na Na Na 20 Na Na 1/17/17 Na FU YMCA Parklawn 12706 SU 35 35 Na Na Na 35 Na Na 1/20/17 Na FR JMJ Partners 11297 B 18 15 Na Na Na 15 Na Na 1/20/17 NA FR Small Steps CC 13406 L 18 17 Na Na Na 17 Na Na
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  • Fall '14
  • supervisor, Na Na Hey Hey Kiss Him Goodbye, Katie Johnson, Jermaine Allen, JMJ Partners

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