West Virginia Department of Education
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This institution is an equal opportunity provider and employer.

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Forms & Reference Tools

Free/Reduced

  • Letter to Households/Household Application/Instructions for Applying/Income Eligibility Guidelines 2013-2014
  • Disclosure Agreement

Meal Patterns/Production Records

  • Meal Patterns
  • Production Record
  • Production Record (Electronic Fillable Form)
  • Sample Production Record

Meal Participation Records

  • POS Regular Version
  • POS Extended Version
  • Daily Records (Monthly Consolidation)

Infants

  • Infant Meal Pattern
  • Obligation to Provide Infant Meals/Meal Patterns Chart/Acceptable Formulas
  • Feeding Infants Guide (USDA)

Special Dietary Needs

  • Sponsor Letter
  • Parent Letter
  • Release of Information for Special Diets
  • Physician Letter
  • Medical Statement
  • Definitions of Disabilities and of Other Special Dietary Needs

Program Requirements

  • Requirements for Key Staff/Annual Training Documentation
  • Multi-Site Monitoring Log and Report
  • Building for the Future
  • Civil Rights/Non-Discrimination Statement
  • Appeal Procedure (.pdf)
  • Outside Employment Policy
  • Formal Bid Contract for Meals
  • At-Risk After School Addendum
  • At-Risk Daily Meal Count Sheet

Family Day Care Homes

  • Budget Worksheet
  • Monitor-Home Ratio Worksheet
  • Key Staff Training
  • Provider Reimbursement Reconciliation Worksheet
  • Sample Letter for Tier I Providers Own
  • Sample Letter for Tier II Options
  • Sample Letter for Parents of Tier II
  • Agreement Form
  • Site Information Sheet
  • Monitoring Form
  • 5-Day Reconciliation

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West Virginia Department of Education
1900 Kanawha Boulevard East, Charleston, WV 25305

(Staff Phone and Email by Name)    (School Directory)

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