Reporting Participation in the Demonstration Project for Non-Congregate Feeding for Outdoor Summer Sites Experiencing Excessive Heat

We need to know about it.

Please utilize the following form to report use of non-congregate feeding for outdoor summer sites experiencing excessive heat. This form will be used to report the site(s), site address(es), date, and number of meals claimed that were taken off-site per each site that is approved to participate in the Demonstration Project for Non-Congregate Feeding for Outdoor Summer Sites Experiencing Excessive Heat. If experiencing multiple excessive heat days, a form will need to be submitted each day. Information reported on this form will be shared with the Arizona Department of Education (ADE) Health and Nutrition Services (HNS).

Please email ContactHNS@azed.gov or call 602-542-8700 if you have any questions in submitting this form.

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* 1. Disclaimer 1: By clicking this box, you are confirming that you have documentation on file to support approval from ADE for all site(s) listed below to participate in the Demonstration Project for Non-Congregate Feeding for Outdoor Summer Meal Sites Experiencing Excessive Heat.

I have documentation to support approval from ADE for the listed site(s)

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* 2. Disclaimer 2: By clicking this box, you are confirming that only the ADE approved site(s) listed below are experiencing a heat advisory/warning on the date listed and have documentation to support this.

I have documentation to support the heat advisory/warning for the date entered

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* 3. Please provide the below contact information.

First name

Last name

Email address

Phone number

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* 4. What is your entity type?

Local Educational Agency (LEA)

Community Organization (CO)