Child Nutrition Meal Pattern Flexibility Waiver Request Form
Submit your request for flexibility or waiver from child nutrition meal pattern requirements. Please complete all fields for evaluation.
Full Name of Requester
*
First Name
Last Name
Organization or Site Name
*
Email Address
*
example@example.com
Child Nutrition Program
*
Please Select
National School Lunch Program (NSLP)
School Breakfast Program (SBP)
Child and Adult Care Food Program (CACFP)
Summer Food Service Program (SFSP)
Seamless Summer Option (SSO)
Other
Meal Pattern Requirement for Flexibility
*
Please Select
Whole Grain Requirement
Milk Variety Requirement
Vegetable Subgroup Requirement
Meal Component Quantity
Sodium Limit
Other
Requested Flexibility/Waiver Period
*
Reason for Flexibility Request
*
Describe the Operational Impact
*
Upload Supporting Documentation (if available)
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Submit Waiver Request
Should be Empty: