DAILY RECORD FORM FOR SCHOOL LUNCH
														           SCHOOL___________________________________

Enrollment ______ = E       Eligible Free______ = EF	  Eligible Reduced______ = ER	     Attendance Factor______ = AF*     Number of Meal Service Days________

Year	Student Lunch/Edit Check	Adult Lunches	Total	Pre K/K Milk       Program	
Comments	
	Maximum Free	Maximum Reduced	

Paid	

Workers Paid	
Total Meals to Children	

Adult Workers	
All Other Adults	

Meal Count	

Milk Served	Eligible Free	

Paid	

Adult		
Month
	
Free	Workers Free	
Reduced	Workers Reduced								
Free				
Date	1a	1b	2a	2b	3a	3b	4	5	6	7	8	9	10	11	12	

																

																

																

																

																

																

																

																

EF-N 79
Revised 10/00

KEY:
Max Free (Column 1) = Eligible Free (EF)  times Attendance Factor (AF)				ATTENDANCE FACTORS:
Max Reduced (Column 2) = Eligible Reduced (ER)  times Attendance Factor (AF)				Elementary	  95%
Max Eligible (Column 4) = Enrollment (E)  times Attendance Factor (AF)					Secondary	  93%

INSTRUCTIONS FOR COMPLETING EF-N-79
DAILY RECORD FORM FOR SCHOOL LUNCH

GENERAL INFORMATION
*Fill in all general information.:  i.e. enrollment, school, eligible free and reduced.

**ATTENDANCE FACTOR is the average percentage of students attending school during a given period.
STATE Factors:  .95 Elementary (K-8); .93 Secondary (9-12)

LUNCHES SERVED TO STUDENTS – CLAIM ONLY ONE MEAL PER CHILD PER DAY FOR ANY STUDENT IN ANY ELIGIBILITY CATEGORY.
		Enter the actual count of reimbursable meals taken at point of service.

Column 1a – “FREE” Students from families meeting the Federal eligibility standards for free meals.

Column 1b – “WORKERS FREE” Students who work for their lunches and qualify for free meals.  The daily total of Columns 1a and 1b should not exceed the number of eligible listed above.

Column 2a – “REDUCED” Students from families meeting the Federal eligibility standards for reduced price meals.  

Column 2b – “WORKERS REDUCED” Students who work for their lunches and qualify for reduced price meals.  The daily total of Columns 2a and 2b should not exceed the number of eligible listed above.

Column 3a – “PAID” Students who have paid or charged their lunches.

Column 3b – “WORKERS PAID” Students who work for their lunch and do not qualify as free or reduced.

*TOTAL ALL COLUMNS DOWN AT THE END OF THE MONTH.

Column 4 – “TOTAL MEALS TO CHILDREN” Add column 4; this should equal 1a+1b+2a+2b+3a+3b across.  Use this as a double check.

LUNCHES SERVED TO ADULTS –Enter the number of lunches served to adults in the proper columns.

Column 5 – “ADULT WORKERS” means school food service personnel and custodians, if applicable.

Column 6 – “ALL OTHER ADULTS” means paying for meals.

TOTAL

Column 7 –“MEAL COUNT” The actual count of the number of meals served.  This should agree with the total of Columns 4, 5, and 6.

Column 8 – “MILK SERVED” Offer vs. Serve schools can record here the number of meals served with milk.

Column 9 – “FREE” Pre-K and K students from families meeting the Federal eligible standards for free milk.  This should not exceed the number of “ELIGIBLE” listed above.

Column 10 – “PAID” Pre-K and K students who have paid or charged their milks.

Column 11 – “ADULT” All adults who have milk during Pre K/K milk program.

COMMENT COLUMN should give reasons for exceeding maximum eligible (Columns 1, 2, and 4) , having a high percentage of free or reduced meals reported for a given day or having higher than normal meal counts, or any other useful comment for future reference (i.e. second meals).

THIS FORM MUST BE RETAINED FOR 3 YEARS FOLLOWING THE YEAR IT WAS COMPLETED.

EF-N-79