CACFP Meal Count Log
Use this form to record meal service counts and reporting details for a CACFP site or center.
Center and Report Details
Center/Site Name
*
Site/Location Code
Reporting Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Meal Service Period (Month Covered)
*
Report Number
Meal Service Counts
Meal Type Served
*
Breakfast
Lunch
Supper
Snack
Number of Enrolled Participants Eligible for Meal Service
*
Number Present/Attending During Meal Service
*
Reimbursable Meal Count
*
Notes for Exceptions, Shortages, or Unusual Circumstances
Preparer Verification
Preparer Name
*
Role / Title
*
Contact Email or Phone
Submission Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Submit
Should be Empty: