Kids Cafe Summer Food Service Application Only nonprofits, churches, and schools within at least a 50% free and reduced lunch area will be accepted. Attach 501(c)3 to this application. Step 1 of 3 33% Is the site a current Kids Cafe?*YesNoIs the site a licensed childcare facility?*YesNoIs the site a non-profit, church, or government entity?*YesNoSite InformationSite Name* Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Check if Mailing Address is different: Check if Different Mailing Address Mailing Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Number of Youth Enrolled:*Program Start and End Dates* MM slash DD slash YYYY Summer End Date* MM slash DD slash YYYY Days of Operation:* Select All Sunday Monday Tuesday Wednesday Thursday Friday Saturday Weekends are not available to all sitesHours of Operation* Hours : Minutes AM PM AM/PM Program End Time* Hours : Minutes AM PM AM/PM Contact InformationSite Supervisor* Prefix Mr.Mrs.MissMs.Dr.Prof.Rev. First Last Supervisor Title* Supervisor Phone*Supervisor Email* Supervisor Date of Birth* MM slash DD slash YYYY Must have for state approvalSite Contact Check if same as Site Supervisor Site Contact* Prefix Mr.Mrs.MissMs.Dr.Prof.Rev. First Last Site Contact Title* Site Contact Date of Birth* MM slash DD slash YYYY Must have for state approval.Site Contact Email* Site Contact Phone/Alternate Number* Meal ServiceWho will you serve?* Enrolled Only Unenrolled - Open to all Youth Both Enrolled and Unenrolled Which meals would you like to serve?* Select All Breakfast Lunch Supper All meals may not be available.Please explain why your site is in need of lunch and supper meals.*Breakfast Meal ServiceNumber of breakfasts to be served daily:*Breakfast Start Time* Hours : Minutes AM PM AM/PM Breakfast End Time* Hours : Minutes AM PM AM/PM Lunch Meal ServiceNumber of lunches to be served daily:*Lunch Start Time* Hours : Minutes AM PM AM/PM Lunch End Time* Hours : Minutes AM PM AM/PM What type of meal would you prefer to serve at lunch?* Select All Cafeteria Style Meals (Hot) Shelf Stable Meals Not all will be available.Supper Meal ServiceNumber of suppers to be served daily:*Supper Start Time* Hours : Minutes AM PM AM/PM Supper End Time* Hours : Minutes AM PM AM/PM What type of meal would you prefer to serve at supper?* Select All Cafeteria Style Meals (Cold) Shelf Stable Meals Not all will be available.Food StorageWhat type of food storage do you have access to?* Select All Commerical Freezer Commercial Refrigerator Residential Refrigerator/Freezer Combo Standup/Chest Freezer Standup Refrigerator None Other Choose all that apply Program InformationIs there a fee for youth to attend?*YesNoPlease explain all fees charged to youth and types of assistance available.*Will students receive academic credit?*YesNoWhy would your site be a good location for a Kids Cafe? What would make it successful?*List all enrichment activities you provide:*If you have completed the enrichment form, put N/A in the box and upload the form with this application (Supporting Documentation.)List any planned closures (including holidays):Comments:Would you be interested in sharing a texting service with parents that would keep them up-to-date about meal services?*YesNoWould like to know moreSupporting Documentation Drop files here or Select files Max. file size: 50 MB. Nonprofit status, Program Descriptions, Enrichment Form, Etc.