SFSP

REQUIRED FORM

         						MEAL COUNT RECORD FOR MONTH OF ____________________________				
							(For Residential and Nonresidential Camps and Enrolled Sites)
    Sponsor Name_____________________________________Site Name_________________________________Site Supervisor_____________________________________________

Day of Month	BREAKFAST	LUNCH	SUPPER	
	Eligible Children	Total
 Children	Non-Program Adults	Total Adults	Eligible Children	Total Children	Non-Program Adults	Total Adults	Eligible Children	Total Children	Non-Program Adults	Total Adults	
1													
2													
3													
4													
5													
6													
7													
8													
9													
10													
11													
12													
13													
14													
15													
16													
17													
18													
19													
20													
21													
22													
23													
24													
25													
26													
27													
28													
29													
30													
31													

TotalDays
Served	Total Eligible Children	Total Children	Non-Program Adults	Total Adults	Total Eligible Children	Total Children	Non-Program Adults	Total
Adults	Total Eligible Children	Total Children	Non-Program Adults	Total
Adults	

	TOTAL CHILDREN and ADULTS
(Eligible And Non-Eligible)                             ►	
	TOTAL CHILDREN and ADULTS
(Eligible And Non-Eligible)                         ►	
	TOTAL CHILDREN and ADULTS
(Eligible And Non-Eligible)                      ►