BACK TO SCHOOL EQUIPMENT GRANT

Dairy Farmers of Wisconsin is excited to announce an equipment grant opportunity to help schools to feed students so they are nourished and ready to learn this coming school year. Our dairy farmers in Wisconsin recognize there may be significant changes in how meals are served and want to support school nutrition departments efforts with equipment. Due to limited funding, only applications that help to support dairy sales in school meals will be considered. Grants are competitive and will be awarded based on strength of plan and potential impact.

School Nutrition Director Name:*
SND Phone Number:*	( ) - Second three digits Last four digits
SND Email:*
SCHOOL INFORMATION Please complete this form for every school you're requesting equipment for.:
School District:*
School Name:*
School Address Equipment Should Be Shipped To:
Street Address 1:*
City:*
State:*
ZIP:*
Do You Have a Dock for Delivery?:*	Yes No Please note, delivery will be second semester of the school year. (March-May)
Enrollment:*
Number of Students - F/R:*
Percent of Students - F/R:*
Community Eligible Provision (CEP) School:*	Yes No School provides free lunch and breakfast to all students
Please Specify the Milk Brand Being Used by Your District:*
EQUIPMENT REQUEST Please select the box next to the equipment you would like to receive. Once you select an item, please explain how the equipment will be used and how it will be used to promote dairy sales. *(View Item Examples)*:
Please Select the Equipment Kit You Would Like to Receive:*	Double Access Beverage Air Milk Cooler Single Access Beverage Air Milk Cooler 3 Milk Crate Coolers please view item examples before selecting Custom Request- Please fill out box below
Custom Request for Dairy Equipment - Please Describe Item and Source/Vendor:	Item must relate to dairy and dairy consumption in school
Please Explain How the Requested Equipment Will Be Used in Your School. :*
I understand that to receive this grant, I must run a dairy promotion during National School Lunch Week and send pictures to dairyinschools@wisconsindairy.org. Failure to do so will result in my application being voided:	Please click the checkbox to agree to the statement
Comments: