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Attachment 4 OFFICE OF SUPERINTENDENT OF PUBLIC INSTRUCTION Child Nutrition Services Old Capitol Building PO BOX 47200 OLYMPIA WA 985047200 (360) 7256200 TTY (360) 6643631 SPECIAL MILK PROGRAM AGREEMENT

How to fill out special milk program agreement

How to fill out the special milk program agreement:

1. Obtain the special milk program agreement form from the relevant authority or organization that administers the program.
2. Read the instructions and guidelines carefully to understand the requirements and obligations involved in participating in the special milk program.
3. Fill in the personal and organization details accurately, including name, address, contact information, and program identification number, if applicable.
4. Provide information about the type of facility or organization participating in the special milk program, such as school, daycare center, or summer camp.
5. Specify the anticipated number of eligible children or participants who will be served milk through the program.
6. Indicate the enrollment period for the program, whether it is for a specific school year, semester, or a defined period of time.
7. Agree to follow the regulations and guidelines set forth by the special milk program, including providing eligible children with the required amount and type of milk.
8. Sign and date the agreement, and ensure that the authorized representative of the facility or organization also signs the document.
9. Submit the completed special milk program agreement to the relevant authority or organization as instructed, ensuring that all required supporting documents are attached, if any.
10. Maintain a copy of the filled-out agreement and any other related documents for your records.

Who needs a special milk program agreement:

1. Public and private schools that participate in the special milk program to provide eligible children with milk at a reduced cost or for free.
2. Child and adult care centers, including daycare centers, nursery schools, and summer camps, that offer milk to eligible participants.
3. Nonresidential childcare institutions, such as after-school programs and community centers, that serve milk to eligible children.
4. Eligible residential child care institutions, including orphanages and group homes, that provide milk to children under their care.
5. Any other authorized organization or facility that aims to offer milk to eligible individuals as part of the special milk program.

For pdfFiller’s FAQs

What is special milk program agreement?

Special Milk Program Agreement is an agreement between a school or institution participating in the Special Milk Program and the state agency administering the program to provide nutritious milk to children.

Who is required to file special milk program agreement?

Schools or institutions participating in the Special Milk Program are required to file the agreement.

How to fill out special milk program agreement?

The special milk program agreement can be filled out by providing information about the school or institution, contact details, milk provider, and other program-specific information.

What is the purpose of special milk program agreement?

The purpose of the special milk program agreement is to ensure the smooth operation of the Special Milk Program and to provide nutritious milk to children.

What information must be reported on special milk program agreement?

Information such as school details, milk provider details, program dates, pricing, and quantities of milk must be reported on the special milk program agreement.

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