Breakfast After the Bell Grant Mock Application

Breakfast After the Bell - School Application

Instructions

Before beginning, please review the instructions page of this form package.

1. List the school/site and building number for which grant funds are requested.

2. Identify whether the school has requested and/or been awarded an exemption to the Breakfast After the Bell requirements.

3. Respond to the questions and provide thorough and detailed responses.

School Application

Name of School/Site: Building Number:

Answers are REQUIRED for all questions on this page.

1. This school currently operates the (check all that apply):

School Breakfast Program (SBP) National School Lunch Program (NSLP)

2. The purpose of this grant is to:

Start a new Breakfast After the Bell Program. Improve an already established Breakfast After the Bell Program.

3. Has this site submitted a waiver to OSPI requesting an exemption to the Breakfast After the Bell requirements?

Yes No

Breakfast After the Bell Grant Mock Application

1. Plan Overview

1.1 What is the current Breakfast Service Model?

1.2 What is the current Breakfast Average Daily Participation (ADP)?

1.3 What type of Breakfast After the Bell Program do you plan to implement?

Breakfast in the Classroom - Breakfast is served in the classroom often during homeroom or first period.

Grab and Go Breakfast - Easy-to-eat breakfast foods are available for students to take at the start of the school day or in between morning classes.

Second Chance Breakfast - Breakfast foods are available during recess, a nutrition break, or later in the morning. For students who are not hungry first thing in the morning, or who arriv late to school.

Other: (please explain below)

1.4 Narrative of your planned Breakfast Model, including overview of the morning schedule.

Breakfast After the Bell Grant Mock Application

2. Planning Process

2.1 Who will you include in the implementation planning meetings?

NAME ROLE

2.2 How will you advertise internally (School Staff)?

2.3 How will you advertise to parents?

Breakfast After the Bell Grant Mock Application

2.4 How will you advertise to students?

2.5 If you would like to be contacted for support, what type of support do you need?

None Equipment ideas Recipe and menu planning Local ingredients and Farm to Breakfast Signage Model Identification School Staff buy-in Outreach Strategies to Families Farm to School Other (please describe)

2.6 Are additional equipment funds needed to fully implement Breakfast After the Bell? If so, do you authorize the release of this application and listed contact information to United Way of King County or other partner organization for the purpose of providing additional support?

Yes No

3. Grant Funding Uses

To implement the plan described above, for which of the following activities or equipment will funds from this grant be used? Check all that apply and give a brief description.

3.1 Salary and Benefits

3.2

3.3

Breakfast After the Bell Grant Mock Application

Equipment

Other Services (including signage and marketing materials, etc.)

I certify that the Nutrition Services Director has reviewed and approved of this Grant Proposal

Name of Site Principal:

Date: (MM/DD/YY)