(Need to have your school deleted? Email Team Nutrition at firstname.lastname@example.org with the school name and address.)
Please complete a form for each individual school, not one for a district.
Enrollment type - Please state if this is: *
We certify our school does not have any outstanding overclaims or significant program violations in our school meals programs.
Public reporting burden for this collection of information is estimated to average 10 minutes per response, including the time for reviewing instructions, searching existing data sources,
gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of
information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing
this burden, to: U.S. Department of Agriculture, Food and Nutrition Services, Office of Research and Analysis, Room 1014, Alexandria, VA 22302 ATTN: PRA (0584-0524). Do not return the completed form to this address.
OMB Control No.: 0584-0524Expiration Date: 04/30/2013