Reporting Participation in the Demonstration Project for Non-Congregate Feeding for the Observation of Ramadan

Please use the following form to report the use of non-congregate feeding for sites that opted into the Ramadan waiver from February 28th through March 30th. This form will be used to report the site(s), site address(es), and number of meals claimed off-site per each site approved to participate in the Non-Congregate Feeding for the Observation of Ramadan. This form will need to be submitted by April 14th, 2025. Information reported on this form will be shared with the Arizona Department of Education (ADE) Health and Nutrition Services (HNS).

If you have any questions about submitting this form, please submit a HelpDesk ticket or contact your assigned specialist.

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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 Ramadan waiver.

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 confirm that only the ADE-approved site(s) listed below are approved to participate in the Ramadan waiver from February 28th, 2025, to March 30th, 2025, and have documentation to support this.

I have documentation to support the February 28th, 2025, to March 30th, 2025 dates 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?

National School Lunch Program Operator

Child and Adult Care Food Provider Operator