CACFP New Sponsor Interest Form

If you are interested in becoming a Sponsor in the Child and Adult Food Care Program (CACFP), complete this form and a representative from our department will contact you regarding next steps.

Sponsor/Center Name *

Sponsor/Center Address - Street *

Sponsor/Center Address - City *

Sponsor/Center Address - State *

Sponsor/Center Address - Zip Code *

Sponsor/Center Federal Employer Identification Number (FEIN) (XX-XXXXXXX) *

Sponsor's Unique Entity Identifier (UEI) Number - if you do not have one yet, enter N/A *

Is this a for-profit or non-profit organization? *

For-Profit (Delaware Business License Required)

Non-Profit (IRS 501(c)(3) Letter Required)

Primary Contact Person (Responsible for CACFP Operations) *

Date of Birth *

Other Names Used for Primary (Maiden Name, Alias, etc.)

Email Address *

Phone Number *

Secondary Contact Person

Other Names Used for Secondary (Maiden Name, Alias, etc.)

Email Address

Phone Number

Have you, as an individual or as a center, ever participated in the Delaware CACFP? *

Yes

Please provide the last date of participation.

Have you, as an individual or center, operated CACFP in any other states? *

Yes

Which state?

Is your facility currently enrolled under a Sponsoring Organization? *

Yes

Sponsoring Organization

Do you participate in any other child nutrition programs? Select all that apply. *

School Breakfast Program (SBP) and National School Lunch Program (NSLP)

Summer Food Service Program (SFSP)

CACFP At-Risk Afterschool Programs

Is this a public, private, or charter school? *

Yes

Are you buying or using a preexisting childcare center? *

Yes

Childcare Center Name

Will you prepare meals at your center or do you purchase meals from a vendor? *

Prepare at site/center

Purchase vended meals

Attestation

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