DoD_Fresh_Program_Information

DoD Opt- In Jotform - Information Sheet
YesNo
CONTRACTING ENTITY INFORMATION
Contracting Entity (CE) Name:*
Name of school district, charter, RCCI or private school as shown in TX-UNPS
CE Identification Number
5-digit number used in TX-UNPS
YESNO
If yes, please email TDA @ commodityoperations@texasagriculture.gov with the following information.

CE ID

CE Name

New Delivery Site (If Applicable)
- New Delivery Site Name
- New Delivery Site Address
New Primary Contact Informaton (If Applicable)
- Name of Primary Contact
- Phone number
- Email
Food Nutrition Director Signature

Entering the Food Nutrition Director's name in these fields serves as an electronic signature. {signatureOf}
Signature of Food Nutrition Director

First NameLast Name
Email
example@example.com
Phone Number

Area CodePhone Number
Date

MonthDayYear
Date
Should be Empty: