Forms ...
Please note that you can view and print the following forms, but you will need Acrobat Reader in order to do so. If you currently do not have Acrobat Reader, click here to download this free software.
ENGLISH (In accordance with Federal law and U.S. Department of Agriculture policy, this institution is prohibited from discriminating on the basis of race, color, national origin, sex, age or disability. To file a complaint of discrimination, write USDA, Director, Office of Civil Rights, 1400 Independence Avenue, SW, Washington DC 20250-9410 or call (800) 795-3272 (voice) or (202) 720-6382 (TTY). USDA is an equal opportunity provider and employer.)
- Child Enrollment Form
Important Note: Providers, give the parent a copy of the completed child enrollment form and the Building for the Future Flyer . Keep a signed copy of the Child Enrollment Form for your own records. - Medical Statement
- Direct Deposit Form
- Building for the Future Poster
- Claim Information Form
- Enrolled Child Meal Benefit Form
- Provider Meal Benefit Form
- Annual Enrollment Status Update
- Kidkare Quick Tips
SPANISH (El Programa de Alimentos para el Cuidado de Niños y Adultos es operado de acuerdo con las pólizas del estado y el USDA, la cual no permite discriminación a base de raza, color, nacionalidad, sexo, edad, o incapacidad. Para registrar un quejo de discriminación, escriba al USDA, Director, Office of Civil Rights, 1400 Independence Avenue, SW, Washington, D.C. 20250-9410 o llame (800) 795-3272 o (202) 720-6382(TTY). USDA es un empleador de oportunidades iguales.)
Solicitud para elegibilidad por ingreso: Nota Importante: Favor de mandar las sies partes de la aplicacion abajo.
- Registro de Niños
Nota Importante: Proveedor(a), suministre una copia de el Registro de Niños adjunto a una copia de Building for the Future Flyer. Tambien, mantenga una copia firmada del formulario de Registro de Niños para sus propios archivos. - Declaración Médica
- Formulario Deposito Directo
- Construyendo para el Futuro
- Formulario Para Beneficios De Alimentos Para NIÑOS Registrados
- Formulario De Proveedor/a Para Beneficios De Alimentos
- Forma de Información de Reclamos
- ACTUALIZACIÓN ANUAL DE ESTATUS DE PARTICIPACIÓN PROGRAMA DE ALIMENTOS
- Padres – Construyendo para el Futuro
- Puntos rápidos de uso
- KidKare Guía de Inicio
Quick Links
In accordance with Federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, the USDA, its Agencies, offices, and employees, and institutions participating in or administering USDA programs are prohibited from discriminating based on race, color, national origin, sex, disability, age, or reprisal or retaliation for prior civil rights activity in any program or activity conducted or funded by USDA.
Persons with disabilities who require alternative means of communication for program information (e.g. Braille, large print, audiotape, American Sign Language, etc.), should contact the Agency (State or local) where they applied for benefits. Individuals who are deaf, hard of hearing or have speech disabilities may contact USDA through the Federal Relay Service at (800) 877-8339. Additionally, program information may be made available in languages other than English.
To file a program complaint of discrimination, complete the USDA Program Discrimination Complaint Form, (AD-3027) found online at:
http://www.ascr.usda.gov/complaint_filing_cust.html
, and at any USDA office, or write a letter addressed to USDA and provide in the letter all of the information requested in the form. To request a copy of the complaint form, call (866) 632-9992. Submit your completed form or letter to USDA by:
(1) mail: U.S. Department of Agriculture
Office of the Assistant Secretary for Civil Rights
1400 Independence Avenue, SW
Washington, D.C. 20250-9410;
(2) fax: (202) 690-7442; or
(3) email: program.intake@usda.gov
This institution is an equal opportunity provider.