2016 Baxter Equipment for Education Grant

Application Preparation Worksheet

This is not the application form. Use this sheet to prepare your responses to the questions on the 2016 Baxter Equipment for Education Grant application. The application must be submitted online via SmarterSelect.com. The application will open on Tuesday, December 1st. Only the first 50 applications will be accepted.

Applicant Information

Name:

Job Title:

Work Address:

City:

State:

Zip:

Work Phone Number:

Work Email Address:

SNA Member ID Number:

School District Information

School District Name:

Federal Tax ID number / 501 (c) 3 designation number:

Number of students enrolled in your district:

Number of schools in your district:

% Free and Reduced:

What type of school foodservice operation does your district have? (Please check all that apply.)

·  On site preparation

·  Kitchen that transports

·  Central Commissary

Was your school district eligible for USDA equipment grants (awarded by the State Agency) in 2015?

Did your school district apply to the State Agency for USDA funding for new equipment in 2015?

Did your school district receive USDA funding through the State Agency for new equipment in 2015?


School Information

Please provide information on the specific school in your district which would receive the piece of equipment if your application won the Baxter Equipment for Education Grant. Please note that only the school listed below is eligible to receive the equipment awarded by this grant. If there are any changes to the school being awarded the grant, you must notify the SNF immediately.

School Name:

School Type:

Number of students enrolled in this school:

ADP of Meals Prepared (as a number):

% Free and Reduced:

ADP Breakfast (as a percent :

ADP Lunch (as a percent):

ADP Snack (as a percent):

ADP Supper (as a percent):

Essay Questions

Help us learn about you and your school nutrition program needs by responding to the below essay questions. The response to each essay question must be between 300-500 words EACH.

Essay Question 1 - Equipment Challenges

What are the current equipment challenges your school foodservice program faces? How have you adapted your program to attempt to overcome these challenges? Please discuss the challenges faced across the school district and in the specific school for which you are applying. Your response must be between 300-500 words.

Essay Question 2 - Impact of Grant

What is the potential positive impact of the equipment grant on your school foodservice program? As you formulate your response, please consider the following:

·  financial impact

·  nutritional impact

·  labor impact

·  increased meal capacity

·  menuing and recipe development

·  design implications

·  increased participation beyond NSLP and NSBP

Please discuss the impact on your entire school district, as well as on the specific school for which you are applying. Your response must be between 300-500 words.

Essay Question 3- Education

How do you think your work as a foodservice director impacts the education of your students? How will attending SNA's Annual National Conference assist you in your work as a foodservice director? Your response must be between 300-500 words.


Certification and Release

By entering my name and date below:

·  I certify that all information on this application is true and complete to the best of my knowledge.

·  I certify that I meet all eligibility requirements as specified in this application and the accompanying instructions.

·  I hereby authorize the School Nutrition Foundation to verify correctness of statements to appraise this application.

·  I hereby authorize the School Nutrition Foundation to utilize information about and from my application for public relations purposes, publicity, or other scholarship opportunities.

·  I hereby authorize the School Nutrition Foundation to share my application with Baxter Manufacturing.

Full Name:

Date (MM/DD/YYYY):