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MENU FORM
Child and Adult Care Food Program
Monday
Breakfast
F/V:
G/B:
Milk:

Tuesday
Breakfast

Diced Peaches
______________________
F/V:
Cheerios
______________________ G/B:
Whole or 1% Milk
______________________
Milk:

Wednesday
Breakfast

Apple Slices
______________________
F/V:
Corn
Muffins
______________________ G/B:
Whole or 1% Milk
______________________
Milk:

Thursday
Breakfast

Diced Pears
______________________
F/V:
Cheerios
______________________ G/B:
Whole or 1% Milk
______________________
Milk:

Friday
Breakfast

Apricots
______________________
F/V:
Pancakes
______________________ G/B:
Whole or 1% Milk
______________________
Milk:

Diced Peaches
______________________
Corn Flakes
______________________
Whole or 1% Milk
______________________

Other: ______________________

Other: ______________________

Vanilla Yogurt
Other: ______________________

Other: ______________________

Other: ______________________

Lunch

Lunch

Lunch

Lunch

lunch

Meatloaf with Gravy

Macaroni & Cheese
Ground Beef
M/MA: ______________________
M/MA: ______________________
M/MA: ______________________
Broccoli
Spinach Salad
Broccoli
F/V 1: ______________________
F/V 1: ______________________
F/V 1: ______________________
Diced Pears
Apricots
Apricots
F/V 2: ______________________
F/V 2: ______________________
F/V 2: ______________________
Long Grain Brown Rice
White Rice
G/B: ______________________
G/B: ______________________ G/B: ______________________
Milk:

Whole or 1% Milk
______________________
Milk:

Whole or 1% Milk
______________________
Milk:

Fish Sticks
Grilled Cheese
M/MA: ______________________
M/MA: ______________________
Mashed Potatoes
Peas and Carrots
F/V 1: ______________________
F/V 1: ______________________
Diced Pears
Apricots
F/V 2: ______________________
F/V 2: ______________________
G/B:

Whole or 1% Milk
______________________
Milk:

Saltine Crackers
______________________
G/B:
Whole
or
1%
Milk
______________________ Milk:

______________________
Whole or 1% Milk
______________________

Other: ______________________

Other: ______________________

Other: ______________________

Other: ______________________

Other: ______________________

Snack

Snack

Snack

Snack

Snack

(Serve 2 of these 4 components)

(Serve 2 of these 4 components)

(Serve 2 of these 4 components)

(Serve 2 of these 4 components)

(Serve 2 of these 4 components)

M/MA: ______________________ M/MA: ______________________ M/MA: ______________________ M/MA: ______________________ M/MA:

100% Apple Juice
100% Apple Juice
F/V:
______________________ F/V:
______________________
F/V:
______________________ F/V:
______________________
F/V:
Saltine Crackers w/ Jelly
Animal Crackers
Rice Cakes
Ritz Crackers
G/B: ______________________
G/B: ______________________
G/B: ______________________
G/B: ______________________
G/B:
Whole or 1% Milk
Whole or 1% Milk
Milk: ______________________
Milk: ______________________ Milk: ______________________
Milk: ______________________ Milk:
M/MA:

Meat/Meat Alternate

F/V:

Fruit/Vegetable

G/B:

Grain/Bread

Other:

Additional items erved but not necessary to meet meal pattern requirements

______________________
______________________
Graham Crackers
______________________

Whole or 1% Milk
______________________

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ISBE 65-11A (9/12)

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