School Food Service Equipment Grant Application Apply Now: District Name* School Name* School Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Applicant's Name* First Last NOTE: Applicant must be employed in the school nutrition department to apply for this grant.Applicant's Job Title:* District School Nutrition Director School Nutrition Manager/ Cafeteria Manager Dietitian/Nutrition Professional Other School Nutrition Employee (specify job title below) "Other" Job Title Phone Number*Applicant's Email Address* Student Enrollment for the 2022-2023 School Year* Does Your School Participate in the National School Lunch Program?* yes no Number of Students Eligible for Free and Reduced Meals in the 2022-2023 School Year at your school* Average Daily Participation for Breakfast: average number of students participating daily in the School Breakfast Program in SY 2022-2023* Average Daily Participation for Lunch: average number of students participating daily in the School Lunch Program in SY 2022-2023* Equipment RequestFrom the Equipment Catalog, write in the equipment you are requesting*Provide a brief description of how the equipment would be used and how it would help increase school meal participation.*Explain how you will help promote your school nutrition program this year.*Do you agree to provide photos and a brief description of the benefits of implementing this equipment at the end of the 2021-2022 school year?*YesNoDo you agree to provide the information below at the end of the 2022-2023 school year*YesNo2022-2023 School Year Data: School; Date of Implementation; Student Enrollment; Number Students Free/ Reduced; Breakfast ADP: Number of Students; Lunch ADP: Number of Students School’s Federal Employer Identification Number (A 9-digit number in the following format XX- XXXXXXX. Also called the Tax ID Number or the Federal EIN. It is NOT the same as tax-exempt number)* School Administrator/Staff InvolvementDistrict School Nutrition Director’s name:* First Last District School Nutrition Director’s email address:* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Check this box to indicate your District School Nutrition Director approves this application and will fully support the selection of the approved school nutrition equipment, if this application is funded.* Yes
