Daily Meal Count Sheet - Arizona Department Of Education
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1Daily Meal Count Sheet
for CACFP At-Risk Programs
Sponsor Name:
Site Name:
Meal Type (circle): B L SN SU
Number of meals prepared or delivered:
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
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18
19
20
21
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27
28
29
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31
32
33
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35
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37
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39
40
41
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46
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48
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50
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54
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56
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58
59
60
61
62
63
64
65
66
67
68
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71
72
73
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75
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77
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80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101 102 103 10 4 105 106 107 108 109 110
111 112 113 114 115 116 117 118 119 120
121 122 123 124 125
126 127 128 129 130
131 132 133 134 135 136 137 138 139 140
141 142 143 144 145 146 147 148
149 150
151 152 153 154 155 156 157 158 159 160
161 162 163 164 165 166 167 168
169 170
171 172 173 174 175 176 177 178 179 180
181 182 183 184 185 186 187 188
189 190
191 192 193 194 195 196 197 198 199 200
201 202 203 204 205 206 207 208
209 210
211 212 213 214 215 216 217 218 219 220
221 222 223 224 225 226 227 228
229 230
231
232 233 234 235 236 237 238 239 240
241 242 243 244 245 246 247 248
249 250
251 252 253 254 255 256 257 258 259 260
261 262 263 264 265 266 267 268
269 270
271 272 273 274 275 276
277 278 279 280
281 282 283 284 285 286 287 288
289 290
291 292 293 294 295 296
297 298 299 300
Total Reimbursable Meals Served to Eligible Participants:
Meals Served to Staff (cannot claim, but must report if over 20% of participant meals):
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
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20
By signing below, I certify the above information is true and accurate:
_______________________________________________________
_______________________
Signature
Date
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