ISBE - New SFSP Sponsor Applications

New SFSP Sponsor Sign-Up

Instructions

Complete the following information and click Submit. In addition to this form, you will need to fax the following items to Naomi Velazquez Greene at 217/524-6124:

Copy of the W-9 form
Documentation of tax-exempt/non-profit status
Program Announcement/Policy Statement
New Sponsor Workshop certificate

Your organization will then be assigned an Agreement Number and contacted regarding an ISBE Web Application Security (IWAS) administrative account.

Sponsor

DUNS #:

(9 digit number, NOT your FEIN/TIN)

If you do not have a DUNS # or need further information please go to http://www.whitehouse.gov/sites/default/files/omb/grants/duns_num_guide.pdf

Sponsor Name:

Street 1:

Street Number
Street Name
Street Suffix

Street 2:

City:

State:

Zip:

County:

Phone:

Fax:

Type

FEIN

Authorized Rep

First:
Middle:
Last:
Title:
Phone:	x
Fax:	x
E-mail:

Contact

First:
Middle:
Last:
Title:
Phone:	x
Fax	x
E-mail:

Food Service

Total number of sites administered
Date first site opens
Date last site closes
Method of meal preparation
YesNo	Will you be using the same menu planning option used during the school year?
YesNo	Will you be implementing Offer versus Serve? (only available to SFAs)

Program Requirements

YesNo	Do you provide an ongoing, year-round service to the community?
YesNo	Have you prepared a letter to notify grassroots organizations in the community of the availability of the program?
YesNo	Have you contacted the local health department informing them of your intent to conduct at food program at the designated site(s)?
YesNo	Do you certify that you will directly operate the program in accordance with USDA regulations and assume total financial responsibility?

Submit
By clicking the Submit button, you certify that all information presented in this form is true and correct to the best of your knowledge. If you agree to these terms, please press Submit.

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