Survey

1. Breakfast Grant Overview

14%

Districts may apply for up to:
$2,000 - Tier 1 districts: Up to 1,000 students
$5,000 - Tier 2 districts: 1,001 to 7,000 students
$7,000 - Tier 3 districts: Over 7,000 students

The amount a school or district is funded depends on the number of students reached. This is a guideline to help you apply for the correct dollar amount.

1. District Information

District Information School District
Enrollment
Name of School Applying
Address of School
City
State
Zip

2. Contact Information

Contact Information Contact Person
Phone
Email Address
Check Mailing Address

3. School District Data

School District Data Free and Reduced Meal Participation
Current Breakfast Average Daily Participation
Current Lunch Average Daily Participation
Do You Serve Universal Breakfast?

4. Please provide average daily participation, school enrollment, and grade levels served for all schools you will be targeting separately. (this may be one or multiple schools)

Please provide average daily participation, school enrollment, and grade levels served for all schools you will be targeting separately. (this may be one or multiple schools)

5. Describe the school(s) current breakfast service to the students. (if one exists)

Describe the school(s) current breakfast service to the students. (if one exists)