Free/Reduced Meal Application

Step 1 of 4

Utah CACFP Enrollment Form/ Free and Reduced-Price Income Application

Complete one application per household. In order to count as enrollment record, Steps 1 & 4 must be completed.
To help answer any questions you may have when filling out these forms, you may download and print these instructions. Download

STEP 1:

List ALL Household Members who are infants, children and students up to and including grade 12
Child 1(Required)
Date

Normal Days and Hours in Care (Include ALL hours the child might be in care) (example: if your child attends Mondays & Wednesdays between 8am - 5pm, and Thursdays between 7am - 3pm, the possible hours your child would be in care during the week are between 7am - 5pm on M, W & TH)

ALL possible days and hours of child's care(Required)
Arrival Time(Required)
:
Leave Time(Required)
:
Check all that apply(Required)

Add Another Child

Child 2
Child 2
Date of Birth

Normal Days and Hours in Care (Include ALL hours the child might be in care) (example: if your child attends Mondays & Wednesdays between 8am - 5pm, and Thursdays between 7am - 3pm, the possible hours your child would be in care during the week are between 7am - 5pm on M, W & TH)

ALL possible days and hours of child's care
Arrival Time
:
Leave Time
:
Check all that apply