My Food Program Software Use Agreement FY2023

This form will allow you to receive a complete Product Quote and Software Use Agreement for the use of My Food Program software. Please complete the fields below. If you have any questions about pricing or software subscription terms, please reach out to Brent Chamberlain, Director of Business Development at brent@myfoodprogram.com

Click here if you would like to see a sample Product Quote and Software Use Agreement before completing this form.

Legal Name of Your Organization
Enter Your Sponsor ID (or Contracting Entity ID) if you'd like it to appear on the agreement:
What site types do you sponsor?

Adult Day Care $55.00 per month per site with attendance or meal counts At-Risk Afterschool $55.00 per month per site with attendance or meal counts Child Care Center $55.00 per month per site with attendance or meal counts Emergency Shelter $55.00 per month per site with attendance or meal counts Family Child Care Home $5.75 per month per site with attendance or meal counts Family Child Care Home $1.15 per month per site with manual claim Summer Food $108.75 per summer for sites with meal counts Summer Food $36.25 per month for sites with meal counts
Authorized Representative for your Organization
First and Last Name
Title
Date

Month Day Year
Date
Signature *

Clear
Where should we email your Software Use Agreement and Terms and Conditions?
example@example.com
Should be Empty:

Authorized Representative for your Organization