Program Name: # of Students Estimated to Eat:
Program Coordinator Name:
Phone: Email:
Area Coordinator Name:
Phone: Email:
Time Snack is Served: Days Needed: Monday Tuesday
Program Start Date: Wednesday Thursday
Program End Date: Friday
Non-Reimbursable Snacks (Billable)
See Cafeteria Manager for snack options and prices.
Program Account #:
Reimbursable Snacks - After-School Care Program (ASCP)
In order to qualify for this feeding program, the school must qualify based on Texas
Department of Agriculture (TDA) qualifiers that may differ each school year. AISD Food
Services will determine eligibility upon receiving the application and will notify the
Program Coordinator.
Students receiving meals must be participating in an after-school program which must
include an educational or enrichment component. Only program participants (students)
may consume the meals.
The accountability options outlined below must be followed or the program will
immediately forfeit eligibility to receive after-school snacks.
Requested Accountability Option: (Check One)
Snacks through the Serving Line Cafeteria staff will handle accountability.
The after-school program will hire an AISD Food Service cashier to administer the snack.
Students will come through the serving line to pick up a snack (two items) and enter their
student ID number.
Cafeteria staff will handle accountability; no further accountability is required from the program
After-School Program Administers Snack Program staff will handle accountability.
The after-school program will assume all responsibility for snack distribution and tracking
according to the federal guidelines of the Child Nutrition Program. Rosters will be provided by
Cafeteria Managers. The after-school program will be responsible for submitting the roster to
the Cafeteria Manager by 10 a.m. the following day.
Completion of an accountability training course is mandatory.
Person(s) administering the meals must complete the online Civil Rights training and attach a
completed Civil Rights Certification to this application. See instructions below.
Person Responsible: Phone:
I understand and accept my responsibilities in operation the federal After-School Care Program
(ASCP). I understand that snack participation will be audited throughout the duration of the
program and I may periodically be asked to provide attendance records to verify students’
eligibility to participate. I will abide by the requirements above or program eligibility will be
Program Coordinator Signature: __________________________________ Date: ___________
Campus Principal Signature: _____________________________________ Date: ___________
FS Area Supervisor Signature: ____________________________________ Date: ___________
FS Assistant Director Signature: __________________________________ Date: ___________
Questions? Please contact your Cafeteria Manager or AISD Nutrition and Food Services at
AISD After-School Snack Application 2
click to sign
click to edit
click to sign
click to edit
click to sign
click to edit
click to sign
click to edit
After-School Care Program (ASCP)
After-School SNACK Program
Civil Rights Training Information
o Read and work through the Civil Rights training linked below:
o Civil Rights Training English
o Civil Rights Training Spanish
o Take the assessment quiz.
o When you have successfully completed the quiz, please fill out the quiz form
o NAME: Your name
o Contracting Entity: Austin ISD
o CS Identification Number: 01068
o Email Address: Your email address
o Date: Today’s Date
o The confirmation sheet will be emailed immediately to the email you provided. Save
the confirmation to your computer, or print a copy, and attach with the completed
o All applications and training documentation may be submitted in-person or
electronically to the Cafeteria Manager. Electronic submissions will be sent to the
Cafeteria Manager’s email address.
AISD After-School Snack Application 3