Summer Food Service Program 2013 Site Application


Application Below


Items denoted with a red asterisk * are required.
A seperate application must be submitted for each individual site.
 * Site Name
 
 * Site's Street Address
 
 * Site's City
 
 * Site's Zip Code
 
 * Site Coordinator's Name
 
 * Site Coordinator's Phone Number
 
 * Site Coordinator's E-mail address
 
 * Estimated number of children at your SSO site
 
 * Type of Site:
 
 * Does a For Profit Organization own this site:
 
 * Days of the week your site will operate.
 
 * Hours of Operation
 
 * Dates of Site Operation
 

(Please list the start and stop date for your site.)
 * Special days site will be closed
 

(List any dates that would fall during your regular operating dates that the site will be closed (i.e.- July 3rd, 2012))
 * Time BREAKFAST will be served.
 

(If your site will not be serving an Breakfast please put NA.)
 * Time LUNCH will be served.
 
 * Program Activities.
 

(A list of activities your site will offer the children is required by the State of North Carolina.)
Additional comments
 

(If you are planning a field trip please list the dates here. You will be required to give no less than 72 hours notice of any field trips)
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