PART III – REQUIRED PROGRAM INFORMATION

I.	Sponsor Information

School District/Sponsoring Organization:

School District/Sponsor Agreement Number:

Has this organization previously received a MA FRESH Grant?	Yes, years No

Has this organization previously received a USDA Farm to School Grant? Yes, years No

What level of funding are you applying for? (Pick one)

Significant Investment: proposals by NSLP or CACFP Sponsors up to $50,000.

NSLP Supporting: proposals by NSLP sponsors $5,000 - $25,000.

CACFP Supporting: proposals by CACFP sponsors $3,000 - $25,000. (ONLY Complete Sections I. Sponsor Information, II. Site Data, III. Proposal sections 1, 4, 5 & 6, and V. Signatures)

Contact information of person responsible for overseeing the grant (Grant Administration Lead):

Name:

Title:

Email Address: Phone Number:

II.	Site Data (Please submit site data below for each school / site where grant activities will take place. See attached II Site Data Continued to list additional sites)

School/Site Name: Site Number:

Data that will be collected from the October 2022 application and claim: Site address, enrollment, and percent of students eligible for free and reduced priced meals.

Meals offered on site: (check all that apply)

Breakfast Lunch Snack Supper Summer Food Service Program (Summer EATS)

What percentage of reimbursable meals served at this site are prepared by a scratch or speed scratch cooking method?

Does this site have an onsite School Garden?	Yes No

*To clarify the meaning of “Scratch” or “Speed Scratch” cooking we will use a burger as an example. Scratch cooking would involve either a burger patty made from ground beef and/or bun made from flour onsite. Speed Scratch would involve a frozen burger patty and a pre-made bun that were cooked and assembled onsite, topped with lettuce and tomato that were sliced onsite. Use of a precooked burger patty would not qualify as scratch or speed scratch.

III.	Proposal	Title of Proposal:

Project Description: Introduce your proposed project.

Plan of Work: Clearly outline up to three goals you plan to accomplish during the grant period. For each goal answer the questions listed. Attach a timeline for activities described over the grant period.

Goal #1:

WHAT activities will need to be completed to achieve this goal?

HOW will success be measured?

Goal #2:

WHAT activities will need to be completed to achieve this goal?

HOW will success be measured?

Goal #3:

WHAT activities will need to be completed to achieve this goal?

HOW will success be measured?

Project Benefit and Results: Describe the intended results and benefits of your project.

Provide estimated projected increases as a result of your project: (only answer those that apply to your proposal)

Number of students educated about MA State farm products.

Number of new MA State farm products to students in schools.

Describe these farm products

Number of new farmers, producers, distributors and/or food hubs supplying MA State farm products to schools.

Increase in dollar amount of MA State farm products procured.

Other anticipated project benefits:

Collaborations: Attach letters of support from any partners outside of your organization (including family day care homes if applicable) to this application. In these letters have each organization / farm describe the support/role they will be providing. Describe the support of partners within your organization including Superintendent/CEO/, teachers, and food service staff.

Personnel Provide name, organization and title of key personnel involved in the project. Outline tasks each position will be responsible for. Describe the experience they bring to this role.

Name:

Organization:

Title:

Tasks they are responsible for and the prior experience they bring to this role:

Name:

Organization:

Title:

Tasks they are responsible for and the prior experience they bring to this role:

Name:

Organization:

Title:

Tasks they are responsible for and the prior experience they bring to this role:

Name:

Organization:

Title:

Tasks they are responsible for and the prior experience they bring to this role:

Budget/Budget Narrative: Complete the attached excel document to communicate the proposed budget by spending category. Submit the budget narrative in a separate word document. Use the budget narrative to explain or justify the estimated costs by line item or category in the budget. Proper budget narratives should explain how the costs associated with each line item or category relate to the implementation of the project as outlined in the proposal being submitted. Sub/recipients should try to anticipate factors that may affect the budget when developing their projections and provide a narrative explanation of those factors. In essence, the budget narrative ties the proposal budget to the proposal deliverables or statement of work.

V.	Signatures

We have reviewed this application and attest to the information provided. If selected, we agree to implement the program as outlined above and to implement the project in a manner consistent with the policies and the procedures established by DESE.

We attest that the School District / Sponsoring Organization is in good standing with the Child Nutrition Program requirements.

We agree to participate in any DESE sponsored evaluations, reporting requirements, and to provide the information requested by the specified deadlines.

Please provide the contacts shown below or equivalent positions as determined by the School District / Sponsoring Organization.

Grant Administration Lead:	Date:

Superintendent or Executive Director:	Date:

II Continued.	Site Data

School/Site Name: Site Number:

Data that will be collected from the October 2022 application and claim: Site address, ages. Grades served, enrollment, and percent of students eligible for free and reduced priced meals.

Meals offered on site: (check all that apply)

Breakfast Lunch Snack Supper Summer Food Service Program (Summer EATS)

What percentage of reimbursable meals served at this site are prepared by a scratch or speed scratch cooking method?

Does this site have an onsite School Garden?	Yes No

Site Data

School/Site Name: Site Number:

Data that will be collected from the October 2022 application and claim: Site address, ages/grades served, enrollment, and percent of students eligible for free and reduced priced meals.

Meals offered on site: (check all that apply)

Breakfast Lunch Snack Supper Summer Food Service Program (Summer EATS)

What percentage of reimbursable meals served at this site are prepared by a scratch or speed scratch cooking method?

Does this site have an onsite School Garden?	Yes No

Site Data

School/Site Name: Site Number:

Data that will be collected from the October 2022 application and claim: Site address, ages/grades served, enrollment, and percent of students eligible for free and reduced priced meals.

Meals offered on site: (check all that apply)

Breakfast Lunch Snack Supper Summer Food Service Program (Summer EATS)

What percentage of reimbursable meals served at this site are prepared by a scratch or speed scratch cooking method?

Does this site have an onsite School Garden?	Yes No