SENDCAA
Child/Adult Care Food Program

CACFP Forms

Click on the links below for CACFP forms (print extra forms or make a photo copy for you records)

After printing your PDF forms, click on the back button on your browser to return to the CACFP website.

Reimbursement Claim Form--make 2 copies

Infant Menu--make 2 copies

Enrollment/Infant Participation Form--make 3 copies

Direct Deposit Form

Infant Formula Participation Form--use this form if an enrollment is already on file at the SENDCAA office and changes need to be made regarding infant formula.

Diet Statement--use this form if you have a child that cannot be served a required component because of an allergy or other medical condition.  This form must be signed by a Physician.

Change Form--use this form if you are changing meal times, meals served, days of week, or formula offered.  Make 2 copies.

Tier I Applications
Below are 3 different Tier I applications.  Click on the appropriate form for your circumstance. Mail completed signed form to the SENDCAA CACFP Office.

Foster Child Living with the Child Care Provider

Parent/Guardian Application of daycare child

Provider Application to Claim Own Children--Proof of income must be submitted with this application.

               SouthEastern North Dakota Community Action Agency
           USDA
             Child/Adult Care Food Program
            3233 South University Drive
           Fargo, ND  58104
           (701) 232-2452
              1 800-726-7960    
               cacfp@sendcaa.org

In accordance with Federal law and U.S. Department of Agriculture policy, this institution is prohibited from discriminating on the basis of race, color, national origin, sex, age or disability.  To file a complaint of discrimination, write USDA, Director, Office of Civil Rights, 1400 Independence Avenue, S.W., Washington, D.C. 20250-9410, or call (800) 795-3272 (voice) or (202) 720-6382 (TTY). USDA is an equal opportunity provider and employer.