Form FNS-891 Team Nutrition School

Appendix_10_Online FNS 891_Team Nutrition School

Create School
OMB Control Number: 0584-XXXX
Expiration Date: XXXX-XX-XX
OMB BURDEN STATEMENT: According to the Paperwork Reduction Act of
1995, an agency may not conduct or sponsor, and a person is not 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-XXXX.
The time required to complete this information collection is estimated to average
10 minutes 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.
Meals Program (Select the USDA’s School Meals Program(s) that your school
participates in (select all that applies))
National School Lunch Program (NSLP)
School Breakfast Program (SBP)
Fresh Fruit & Vegetable Program (FFVP)
Special Milk Program (SMP)
Afterschool Snacks
Seamless Summer Option (SSO)

School Information
SCHOOL NAME
STREET ADDRESS
STREET ADDRESS LINE 2
CITY
DISTRICT
COUNTY
STATE

ZIP CODE
SCHOOL PHONE
TOTAL ENROLLMENT
SCHOOL WEBSITE (http://www.example.com)

School Type
Elementary
Middle
High
Charter
RCCI
Other
Grade Levels
Pre-K
Kindergarten
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5
Grade 6
Grade 7
Grade 8
Grade 9
Grade 10
Grade 11
Grade 12

Team Nutrition Information
TEAM NUTRITION LEADER NAME
TEAM NUTRITION LEADER EMAIL
TEAM NUTRITION LEADER PHONE
SCHOOL PRINCIPAL NAME
SCHOOL PRINCIPAL EMAIL
CAFETERIA MANAGER NAME
CAFETERIA MANAGER EMAIL ADDRESS

WELLNESS COORDINATOR NAME
WELLNESS COORDINATOR EMAIL ADDRESS

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LEGACY URL (Temporary field to be used for Migration audit.)
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