Child Enrollment Form

Name of Institution: Community Action Program of Evansville

Sponsor ID Number: 1820162



Please enter the normal hours your
child is in care on the specific days of
care

Please select the meals your child
normally receives while in care


Monday


Tuesday


Wednesday


Thursday


Friday


Saturday


Sunday



FOR INFANTS ONLY: All facilities must offer infant formula and meals / snacks to infants in care during meal service
times.

Infant Formula

Infant Meals and Snacks


This information is required by CACFP federal regulations at §226.15 (e)(2) and (3) for each enrolled participant, and must be updated annually.


This institution is an equal opportunity provider