Mcps Form 240-53 - Child Care Food Program Cycle Menus And Change Request

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Division of Food and Nutrition Services
CHILD CARE FOOD PROGRAM
MONTGOMERY COUNTY PUBLIC SCHOOLS
CYCLE MENUS AND CHANGE REQUEST
8401 Turkey Thicket Drive, Gaithersburg, Maryland 20879
INSTRUCTIONS: If you have more than three (3) days in one weekly cycle where meals served differ from those listed on the
original Cycle Menu, complete that week’s menu on the regular menu form.
Provider
Vendor #
Home Phone (
)
Month
Address
Street
City
State
Zip
Cycle Menu #
for period
/
/
to
/
/
Meal
Day:
Day:
Day:
Breakfast
A.M. Snack
Lunch
P.M. Snack
Supper
Cycle Menu #
for period
/
/
to
/
/
Meal
Day:
Day:
Day:
Breakfast
A.M. Snack
Lunch
P.M. Snack
Supper
Cycle Menu #
for period
/
/
to
/
/
Meal
Day:
Day:
Day:
Breakfast
A.M. Snack
Lunch
P.M. Snack
Supper
Cycle Menu #
for period
/
/
to
/
/
Meal
Day:
Day:
Day:
Breakfast
A.M. Snack
Lunch
P.M. Snack
Supper
Cycle Menu #
for period
/
/
to
/
/
Meal
Day:
Day:
Day:
Breakfast
A.M. Snack
Lunch
P.M. Snack
Supper
NOTE: This is a multipart form. No carbon paper is required. Remove 2 copies and complete.
MCPS Form 240-53, Rev. 1/16
DISTRIBUTION: COPY1/MCPS Division of Food and Nutrition Services; COPY 2/Provider

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