Child & Adult Care Food Program DAILY ATTENDANCE AND MEAL COUNT ROSTER (A) FORM TYPE (check only one):        Daily Attendance Breakfast Snack Lunch Pm Snack Supper Snack Am Eve (B) MONTH & YEAR: ____________________________ (C) CALENDAR DATES: (F) (D) FIRST & LAST NAMES: M TU W TH F M TU W TH F M TU W TH F M TU W TH F M TU W TH F TOTALS: (E) DAILY TOTALS: _________________________________________________ ___________________________ Signature Date
Child & Adult Care Food Program DAILY ATTENDANCE AND MEAL COUNT ROSTER (A) FORM TYPE (check only one):  Daily Attendance  Breakfast  Am Snack  Lunch  Pm Snack  Supper  Eve Snack (B) MONTH & YEAR: ____________________________ (C) CALENDAR DATES: (D) FIRST & LAST NAMES: M TU W TH F M TU W TH F M TU W TH F M TU W TH F M TU W TH F (F) TOTALS: (E) DAILY TOTALS: _________________________________________________ ___________________________ Signature Date
Form_10C_Daily_Attendance_Or_Meal_Count_By_Type_01_2013.docx