Food Program Forms

Here you'll find links to common Food Program forms and documents.  Please contact us if you have any questions regarding any of the materials below.

Food Claims

Claim Information Form | download pdf

Certification Statement | download pdf 

Claim Adjustment Request | complete online / download pdf

Formula Agreement - English | download pdf

Formula Agreement - Español | download pdf

One Infant Meal Component Provided by Parent | complete online

Developmentally-Ready Infants Fed Different Foods | complete online

Special Diet/Non-Dairy Substitute Form | download pdf

Special Needs Verification Form | download pdf

School Age Verification for Child 5 yrs - Licensed Provider | complete online / download pdf

Financial


Direct Deposit Form and Instructions | download pdf

Household Size-Income Scale for USDA Nutrition Programs | download pdf

Income Form - Area (Yellow) | download pdf

Income Form - Household (Blue) | download pdf

Income Form - Parent (Orange) | download pdf

Required Documents


2019 WECA Food Program Provider Training| Create a Free account through TalentLMS to complete the course. 
Statement for Providers with Assistants | complete online / download pdf