Child Feeding Programs Monthly Report

Child Feeding Program Monthly Report

Did you have a health department visit this month?


Ages of Children Attending This Month

Fields marked with "B" + "C" + "D" + "E" + "F" should equal "A" above.

Over 18 but still in high school.
Fields marked with "G" + "H" + "I" + "J" + "K" + "L" + "M" should equal "A" above.

Count every child who took home a backpack this month.


UNPAID STAFF are regular helpers who play vital roles in the operation of your program but do not get paid. At some sites, the director is unpaid. This person would be considered an UNPAID STAFF member. However someone who occasionally volunteers to help with homework (and does not get paid) would be considered a VOLUNTEER.

Staff (including site director)


Please do NOT include unpaid staff.


Planned Educational Activities

Special Activities

Regular Activities