Cacfp Enrollment Form Options printable pdf download

Cacfp Enrollment Form Options

CACFP

ENROLLMENT FORM OPTIONS

Requirements:

a. CACFP child care centers and Head Start centers must have a completed Enrollment Form on file

for each enrolled child.

b. Enrollment Forms are only valid up to 12 months following the month of receipt and determination

and must be completed annually by parent or guardian.

c. For ease of collection, it is highly recommended that agencies/centers distribute enrollment forms

to parents/guardians at the same time as the Income Eligibility Application so that it is more likely

that the forms would expire on the same date.

d. The following program types DO NOT need enrollment forms:

• Outside-School Hours Centers

• Youth Development Programs

• After School At Risk Programs

• Emergency Shelters

Enrollment Form Options (Form A, B, C or D)

1. Use CACFP Prototype Enrollment Form

: See Form A and Example Form A

• All parts of form completed by parent/guardian including normal days, hours and meals

2. Use CACFP Prototype Enrollment Form (Form A) with Daily Parent Sign-in and Sign-out

Records

See Example B or Form C

• Prototype form not completed regarding normal days, hours and meals (Example B) or form

does not contain information regarding normal days, hours and meals (Form C)

• Keep on file daily parent sign-in and sign-out records for the center

3. Use Ohio Department of Job and Family Services (ODJFS) Child Enrollment and Health

Information Form (3 pages) with Daily Parent Sign-in and Sign-out Records

: See Form D

• ODJFS form must be completed by parent and completed annually

• ODJFS form can only be used if parents sign their child in and out each day

• Keep on file daily parent sign-in and sign-out records for the center

Develop own enrollment form with required information

• Form can reflect only the meals served by the center and days open

• Form must be approved by State Agency prior to use

Revised 2/23/2011

Cacfp Enrollment Form Options