Form FNS-822 Annual Fresh Fruit and Vegetable (FFVP) Participation Re

UNITED STATES DEPARTMENT OF AGRICULTURE - Food and Nutrition Service

ANNUAL FRESH FRUIT AND VEGETABLE PROGRAM (FFVP) PARTICIPATION REPORT

OMB APPROVED NO. 0584-XXXX
Expiration Date: XX/XX/XXXX

OMB PAPERWORK COLLECTION STATEMENT: According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information

unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0584-00XX. The time required to complete this
information collection is estimated to average 1.5 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and
maintaining the data needed, and completing and reviewing the collection of information.
State Agency
School Year
School Food Authorities (SFA)
participating in the FFVP

FORM FNS-822 (04-12) Previous Editions Obsolete

List of schools that applied

SBU

Enrollment of
applicant school

Free and reduced
price percentage of
applicant school

Check schools
selected to
participate

Per student
funding
provided

Electronic Form Version Designed in Adobe 9.1 Version

ANNUAL FRESH FRUIT AND VEGETABLE PROGRAM (FFVP) PARTICIPATION REPORT INSTRUCTIONS
Below is an explanation of what information to include in each column of the chart:
1. School Food Authorities participating in the FFVP: List all School Food Authorities that have
schools that applied to participate in the FFVP.
2. List of schools that applied: Name all elementary schools in your state that applied for the
FFVP.
3. Enrollment of applicant school: Indicate the total number of students enrolled in each school
that applied.
4. Free and reduced price percentage of applicant school: Indicate the percentage of students
eligible for the free and reduced price lunch program in each school that applied.
5. Check schools selected to participate: Indicate whether the school was selected to participate
in the FFVP by checking this box.
6. Per student funding provided: Indicate funding provided per student in each school.
Participating schools must receive funds based on an allocation of $50 - 75 per student as
determined by the State Agency.
Example:
School Food
Authorities (SFA)
Participating in
the FFVP
Middle City

List of schools
that applied
Main Street
Elementary School

Free and reduced
Check
Enrollment
price percentage
schools
of applicant
of applicant
selected to
school
school
participate
723

91%

X

Per student
funding
provided
$55.00