Yukon Food for Learning

1

Yukon Food for Learning Association

Grant Application - 2016/17 School Year

Section 1General Information

School: ______

ContactPerson: ______Phone: ______

Email: ______

Section 2Funding Requested for 2016/17

2015/16 School Year

YFFLA Funding: ______

Funding from all other sources: ______

Total Funding: ______

2016/17 School Year

YFFLA Funding Requested ______

Expected funding from all other sources______

Total Funding: ______

If you are requesting an increase, please explain why you feel you need increased funding for the 2016/17 school year: ______

______
______

Please include either the originals or a copy of all receipts for food, etc purchased with YFFLA funding. Your grant will not be considered until those receipts are received

Section 3Program Description

Number of students expected for the 2016/17 School Year: ______

Number of Grades ______

What type of school food program do you offer?

Meal Type

Yes/No

Number of Days per Week

Number of Students per Week

Breakfast

Lunch

AM Snack

PM Snack

Other information about your school food program: ______

______

______

______

Please attach supply a sample weekly menu:

Section 4Program Improvements

Are there any program changes you are planning for the upcoming school year?

______

______

______

Do you have any suggestions that would make the YFFLA granting process work better?

______

Section 5Agreement and Signatures

If a grant is provided, the recipient agrees to the following:

• The recipient will provide before the end of December, Monthly Reports of the types of meals provided and the number of students served between Aug/Sept and December as well as a Mid –Year FinancialReport.
• At or before the end of the school year, the recipient will provide Monthly Reports of the types of meals provided and the number of students served between Jan and June as well as a Year End FinancialReport.
• Upon request, the recipient will permit YFFLA or persons authorized by it to perform areview and/or evaluation of the activities for which the funds were granted.
• The recipient will abide by all other terms and conditions of the grant that may be imposed by YFFLA at the time of funding.

The recipient will ensure the funded program embraces YFFLA’s Vision & Mission.

Our vision is a Yukon where every student has access to nutritious healthy food while at school.

YFFLA will support school based nutrition programs and will encourage lifelong healthy eating programs.

Section 7Authorization and Execution

Authorization must be signed by the school principal or vice-principal.

The undersignedhereby certify that the above information is true and accurate.

______

NameTitle

______

SignatureDate

Please return by Email to or by mail to

K:\A - YFFLA\F - Communications\D - Printed Material\C - Forms & Labels\B - Forms\YFFL Grant Application 2015.docx

December 16, 2018