Food Program Corrections to Child Information

I HEREBY CERTIFY to the best of my knowledge that this information is true, correct, and in accordance with the terms of our existing agreement and that records are available to support this information. I understand that this information is being given in connection with the receipt of federal funds and that deliberate misrepresentation may subject me to prosecution under applicable state and federal criminal statutes.”

For other questions and changes not listed below, email Margaret.

Reminder: If a child can’t eat or drink what is required by the USDA Food Program, or if you have questions about it, please email the WECA Food Program.

Food Program Corrections to Child Information

Your Six-Digit WECA CACFP Provider Number

Your First and Last Name

Child's ID (choose 1-35)

Child's Full Name

Select which of the following you are correcting: Select which of the following you are correcting: Spelling of Child's Name Child's Date of Birth Child's Date of Enrollment

Correct Spelling of Child's Name:

Correct Date of Birth

Correct Date of Enrollment

4 + 10 =