Initial CACFP Application Form

Initial CACFP Application Form

Complete these initial fields below to start your CACFP application process!
User Information
Company*
Center or organizational name
Your First Name*
Your Last Name*
Title/Position*
E-mail*
Phone Number*

Area CodePhone Number

Pre-Qualification Information

This information will gather some initial information that will be needed in order to confirm if you are eligible to participate on the CACFP.
CACFP program type you are applying for?*
CACFP Participation Status*
Do you have affiliated or unaffiliated sites?*
Affiliated sites indicate that you have multiple sites under the same organization. Unaffiliated sites are not associated with each other under a central organization.
Number of centers/sites you will be applying for*
If operating a child or adult care facility, what is your current license status?*
In order to submit a CACFP application, a valid license is required from the applicable agency (TDPRS for child care, DADS for adult care). Enter Not Applicable if you only have At Risk sites.
License capacity*
Enter 0 if you only have At Risk sites.

Estimate Your Reimbursement!

Complete the fields below to estimate the benefits your organization could receive from participating on the CACFP!
Total Enrollment (All Sites)*
Number of Low Income Participants (Free/Reduced Participants, such as those on CCMS, NCI, etc.)*
Include any participants whose household income fits the chart below.
Number of participants served daily (All Sites)
Breakfast*
Enter 0 if your site(s) do not serve Breakfast.
Lunch*
Enter 0 if your site(s) do not serve Lunch.
PM Snack*
Enter 0 if your site(s) do not serve PM Snack.
Supper
Enter 0 if your site(s) do not serve Supper.
At Risk PM Snack
Enter 0 if your site(s) do not serve PM Snack for At Risk afterschool.
At Risk Supper
Enter 0 if your site(s) do not serve Supper for At Risk afterschool.
Estimated Monthly Reimbursement
Additional Comments
Once you submit this form, you will receive an email confirmation confirming your submission.

Please complete the next step in your application process at www.gocacfp.com/apply.

Congratulations on taking your first step toward applying to participate on the Child & Adult Care Food Program!
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User Information