Child And Adult Care Food Program Center Site Claim - Arizona Department Of Education
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1ARIZONA DEPARTMENT OF EDUCATION
CHILD AND ADULT CARE FOOD PROGRAM CENTER SITE CLAIM
th
Claims must be received by the 10
of the month following the claim month. Claim(s) are to be submitted
electronically at the CNP Web at https:// Sponsor must retain a copy of
claim for permanent record.
CTD #
Sponsor
CTDS #
Site Name
Address
(
)
Phone
Type of Submission: Original
Claim Month/Year:
Revision
____________________
Date of Revision: _____________
Program Participation
Maximum Days Served
Average Daily Participation
Participants Approved for Free Meals
Participants Approved for Reduced-Price Meals
Participants Approved for Paid Meals
Participants Enrolled
Number of Enrolled Participants Receiving Title XIX or XX Benefits
Reimbursable Meals Served
Breakfast
Morning Snack
Lunch
Afternoon Snack
Supper
Evening Snack
At-Risk After School Snack
I:\Health_and_Nutrition\CACFP\Centers\General Documents\2008\CNP Web & Claiming Info\Site Claim Worksheet.doc
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