Food Fundraisers

Transcription

Food Fundraisers
Request for Fundraiser
School Year:
2015-2016
1 Date of Fundraiser: ____M_a_rc_h_-_A...:..p_ri_l2_0_1_6_ __
Description of Fundraiser:
Is this fundraiser request to sell a food item?
D
No
JBI Yes 6
Describe what expenditures you would have with this
fund raiser? [Cost to purchase the product, cost to make the
product to sell, etc ... ]
Estimated Expenses
Proceed with Page 1 Only
If yes, please complete this page & page two to determine
eligibility for food fundraiser.
Ice Cream, pop, candy, cups, popcorn
I $ 300
Estimated PROFIT
Is this fundraiser an event or activity that will be held at a specific location?
6 If yes, where: TAKE II
I $ soo
0Yes 6
If this fund raiser is an event or activity that will be held on school property, please contact the Business Office to inquire about facility usage costs
that may be incurred with usage (580-221-3001 Ext 220). All applications for facility usage must be submitted at least 30 days prior to event.
Is this fundraiser a raffle?
6
0Yes 6
If yes, you must submit a request to the Board of Education asking for your specific raffle items to be approved prior to this being submitted to
the BOE for approval as required in Board Policy FG-B. Also see Administrative Procedure FG-B .1 for guidelines for raffles .
FOR CENTRAL OFFICE ADMINISTRATION ONLY
Date Received by Business Office .___ _ _ _ _ _ _ _ _ _ _ ········~:~t.~t.~di~u~l~·1m1Dim•1mlr~lt~5Di~[.~]~·········
Date Received by Supt Office ' - - - - - - - - - - - - - - - '
Superintendent :
_Approved
Denied
_Approved
Denied
Date:
Superintendent Signature
I
Oth"
Board Signature
••••••••••·!NCTnm!n~k!~ ; !}~.:~, ~".1~ ~-h·~u~-••••••••••'
8
list in detail the food
items you are proposing
1
Take II
L.;;;.!SwiMffi.!J
#fflffilih-
Ice Cream , pop, candy, cups, popcorn
Please review and select which option below describes your food fundraiser
D
OPTION 1
My food items ARE NOT ready to consume-type items and can be sold during
the school day [12 a.m. to 4 p.m.]
~
..........m
. .-....... .
My food items ARE ready to be consume-type AND I want to sell them during the
sch~ld/':~a.mt 4p.m~ ~!Iff,
t~is opt~n s~te~~lc~'t?;t~ol
If thrs option is selected, no calculator tool is necessary.
fhf})
Will
cd P~
I
is
is required to determine if your food items can
be approved. Please complete the calculator tool. If your items pass the calculator test,
please attach a copy of the test approval and a copy of the food label(s) to this fundraiser
request and submit to your principal for their approval and then to the Business Office. If
your food item(s) do not pass the calculator test, then you will not be able to have the
fundraiser.
Calculator tool: http://healthymea ls. nal. usda.gov/sm artsn acks
D
D
OPTION 3
My food items ARE ready to consume-type items, however, I will not be
selling them during the school day [12 a.m . to 4 p.m.]
OPTION4
My fund raiser is a brochure or catalog and my items will not be released to
students until the end of the school day.
If this option is selected, no calculator tool is necessary.
My signature below affirms my choice of:
D
Option1
~Option 2
I furt~er agree to abide by the federal regulations within my
0CMA£JJ f3~
Sponsor
D
Option 3
D
Option 4
Fundraiser Exemption
School Site: Take II
Fundraiser approved for Exemption: Popcorn
Dates of Fundraiser: April 4-8,
Principal Signature:
2016
~~
Date Approved:
__ of 30 Fall 2015
Fundraiser Exemption
School Site: Take II
Fundraiser approved for Exemption: Root Beer Floats
Dates of Fundraiser: March 9-10 ,
2016
Sponsor Signature:
Principal Signature:
Date Approved:
__ of 30 Fall 2015
Fundraiser Exemption
School Site: Take II
Fundraiser approved for Exemption: Candy and Pop for Walk-A-Thon
Dates of Fundraiser: March 11,
2016
Sponsor Signature:
Principal Signature:
Date Approved:
__ of 30 Fall 2015
Request for Fund raiser
School Year:
2015-2016
Date of Fundraiser: _ _ _ _0_9_10_9_1_20_1_5_ _ __
Transportation fees . students & teachers incentives, field trips , pe equipment, playground
equipment, classroom supplies, Alan Jonnson, covered walkway
Indian Teritory Foods , Inc
Description of Fundraiser:
Otis Spunkmeyer Cookie Dough
Is this fundraiser request to sell a food item?
D
No
:0 Yes !:::.
Proceed with Page 1 Only
If yes, please complete this page & page two to determine
eligibility for food fundraiser.
Describe what expenditures you would have with this
fund raiser? [Cost to purchase the product, cost to make the
product to sell, etc ... ]
Estimated Expenses
I $200.00
Estimated PROFIT
Is this fund raiser an event or activity that will be held at a specific location?
!:::. If yes, where:
I $10,000
Ovest:::.
If this fundraiser is an event or activity that will be held on school property, please contact the Business Office to inquire about facility usage costs
that may be incurred with usage (580-221-3001 Ext 220). All applications for facility usage must be submitted at least 30 days prior to event.
Ovest:::.
Is this fund raiser a raffle?
!:::.
If yes, you must submit a request to the Board of Education asking for your specific raffle items to be approved prior to this being submitted to
the BOE for approval as required in Board Policy FG-B. Also see Administrative Procedure FG-B.l for guidelines for raffles.
FOR CENTRAL OFFICE ADMINISTRATION ONLY
Date Received by Business Office
Superintendent:
_Approved
Denied
_Approved
Date Received by Supt Office
Denied
Date:
Superintendent Signature
I
Othec
Board Signature
Will Rogers Elementary
Otis Spunkmeyer Cookie Dough Brochure items
List in detail the food
items you are proposing:
Please review and select which option below describes your food fund raiser
D
My food items ARE NOT ready to consume-type items and can be sold during
the school day [12 a .m. to 4 p.m .]
D
If this option is selected, no calculator tool is necessary.
My food items ARE ready to be consume-type AND I want to sell them during the
school day. [12 a.m . to 4 p.m.]
If this option is selected, the calculator tool is require d to determine if your food items can
be approved. Please complete the calculator tool. If your items pass the calculator test,
please attach a copy of the test ap proval an d a co py of t he food label(s) to this fundraiser
request and submit to your principal fo r their app roval and then to the Business Office. If
your food item(s) do not pass the calculator test, then you will not be able to have the
fu ndraiser.
Ca lculator tool : http://healthymeals.nal.usda.gov/smartsnacks
D
0
My food items ARE ready to consume-type items, however, I will not be
selling them during the school day [12 a.m . to 4 p.m .]
My fund raiser is a brochure or catalog and my items will not be released to
students until the end of the school day.
If this option is selected, no cal culato r tool is necessary.
My signature below affirms my choice of:
D
Option!
D
Option 2
D
Option 3
I further agree to abide by the federal regulations within my chosen option.
~~~
Sponsor
I•
\
c=L-,v
Prin'V~
IV I
Option 4
Request for Fundraiser
School Year: __2_0_15_-2_0_16__
Date of Fundraiser: _____s_e;_pt_1_-_16_ _ _ __
833
1
1
wa;;.m .11 M!ffli.l§ w
Description of Fundraiser:
sell blue and gold products , such as sausage, chicken strips, and bacon
Is this fund raiser request to sell a food item?
D
No
E ves 6
Describe what expenditures you would have with this
fund raiser? [Cost to purchase the product, cost to make the
product to sell , etc ... ]
Estimated Expenses
Proceed with Page 1 Only
If yes, please complete this page & page two to determine
eligibility for food fundraiser .
Cost of product $ 1600
I$
Estimated PROFIT
Is this fundraiser an event or activity that will be held at a specific location?
6 If yes, where :
I $ 600
~No
Oves6
If th is fundraiser is an event or activity that will be held on school property, plea se contact the Business Office to inquire about facility usage costs
th at may be incurred with usage (580-221 -3001 Ext 220). All applications for facility usage must be submitted at least 30 days prior to event.
Is this fund raiser a raffle?
Oves6
6
If yes, you must submit a request to the Board of Education asking for your specific raffle items to be approved prior to this being subm itted to
the BOE for approval as required in Board Policy FG -B. Also see Admin istrative Procedwe FG -B.1 for guidelines for raffles .
Sponsor's Name
Principal/ Admin Name
FOR CENTRAL OFFICE ADMINISTRATION ONLY
Date Received by Supt Offi ce
Superintendent :
_
L___ _ _ _ _ _ _ _ _ ____J
Approved
Den ied
_
Approved
Denied
Date :
Superintendent Signature
I
Oth"
Board Signature
~&!·l'~lil!m·IJ J
Sausage, bacon and chicken strips (All raw products)
List in detail the food
items you are proposing:
Please review and select which option below describes your food fundraiser
~
D
My food items ARE NOT ready to consume-type items and can be sold during
the school day [12 a.m. to 4 p.m .]
If this option is selected, no calculator tool is necessary.
My food items ARE ready to be consume-type AND I want to sell them during the
school day. [12 a.m . to 4 p.m.]
If this option is selected, the calculator tool is required to determine if your food items can
be approved. Please complete the calculator tool. If your items pass the calculator test,
please attach a copy of the test approval and a copy of the food label(s) to this fundraiser
request and submit to your principal for their approval and then to the Business Office. If
your food item(s) do not pass the calculator test, then you will not be able to have the
fundraiser.
Calculator tool : http://healthymeals.nal.usda .gov/smartsnacks
D
D
My food items ARE ready to consume-type items, however, I will not be
selling them during the school day [12 a.m. to 4 p.m .]
My fundraiser is a brochure or catalog and my items will not be released to
students until the end of the school day.
If this option is selected, no calculator tool is necessary.
D
D
D
" . - . -••Ifo.rt~e: ·~:~~ t: •b;de the fede.•l .egulot;on• w;th~ii~
IV' I
My signature below affirms my choice of:
*
--
Option 1
Option 2
by
Principal
Option 3
Option 4
Request for Fundraiser
School Year: __2_0_15_-2_0_1_6 _
I
Date of Fundraiser: _ _ _ _ _
se....;.p_t_1-_1_
6 _ _ __
sell blue and gold products , such as sausage, chicken strips , and bacon (raw products)
Is this fund raiser request to sell a food item?
0
E
No
ves
Proceed with Page 1 On ly
6
If yes, please complete this page & page two to determine
eligibility for food fundraiser.
Describ e w hat exp endit ures yo u would have wit h thi s
fun d raiser? [Cost to purch ase th e produ ct , cost to m ake the
produ ct t o se ll , et c ... ]
Estimated Expenses
Cost of product $ 1600
I $ 1600
Estimated PROF IT
Is this fund raiser an event or activity that will be held at a specific location?
I $ 600
~No
Oves 6
6 If yes, w here:
If this fundraiser is an even t or activity that wi ll be he ld on school pro perty, pl ease co ntact t he Busi ness Office t o inquire about fa cility usage costs
t hat may be incurred with usage (580-221-3001 Ext 220). All appl icatio ns for faci lity usage must be subm itt ed at least 30 days prior t o event.
Is this fund raiser a raffle?
Oves 6
6 If yes, you must su bmit a request to the Board of Education asking fo r yo ur specific raffle items to be approved prior t o t his bei ng subm itted to
t he BOE for approval as re qu ired in Board Po licy FG -B. Al so see Administ rative Proce dure FG -B. 1 for guidelines fo r raffl es.
Sponsor's Name
Principal/Admin Name
FOR CENTRAL OFFICE ADMINISTRATION ONLY
Date Received by Business Office
L------------········~:l~·i!·i~;!~·i~·~lil!!i•milmtlt!·~Si~l·~l~~••••••••
Date Received by Supt Office L-----------~
Superintendent:
_
Approved
Denied
_App rove d
Denied
Date:
Su perintendent Signature
Board Sig natu re
~,;,;,....-..J
~
5
-
List in detail the food
items you are proposing:
Sausage, bacon and chicken strips (All raw products)
Please review and select which option below describes your food fund raiser
~
My food items ARE NOT ready to con sume-type items and can be sold during
the school day [12 a.m. to 4 p.m.]
D
If this option is selected, no calculator tool is necessary.
My food items ARE ready to be consume-type AND I want to sell them during the
school day. [12 a.m. to 4 p.m.]
If this option is selected, the calculator tool is required to determine if your food items can
be approved. Please complete the calculator tool. If your items pass the calculator test,
please attach a copy of the test approval and a copy of the food label(s) to this fundraiser
request and submit to your principal for their approval and then to the Business Office. If
your food item(s) do not pass the calculator test, then you will not be able to have the
fundraiser.
Calculator tool : http://healthymea is.nal.usda .gov/smartsnacks
D
My food items ARE ready to consume-type items, however, I will not be
selling them during the school day [12 a.m . to 4 p.m.]
D
My fund ra iser is a brochure or catalog and my items will not be released to
students until the end of the school day.
If this option is selected, no calculator tool is necessary.
My signature below affirms my choice of:
Ivi option 1
D
Option 2
D
Option 3
D
Option 4
I further agree to abide by the federal regulations within my chosen option_
' 7'
'
ww•~ ~-~~rL
r v
w-
Principal
~~~G~lMloM - .
Request for Fund raiser
School Year: __2_o_1s_-_16_ _
Date of Fund raiser:
September 4-14
--------~-------------
Description of Fund raiser:
Misc. catalog items
Is this fund raiser request to sell a food item?
D
m
No
Proceed with Page 1 Only
Yes D.
If yes, please complete this page & page two to determine
eligibility for food fundraiser.
Describe what expenditures you would have with this
fundraiser? [Cost to purchase the product, cost to make the
product to sell, etc ... ]
Estimated Expenses
None
I $o
Estimated PROFIT
Is this fundraiser an event or activity that will be held at a specific location?
I $ 3000.00
Oves D.
D. If yes, where :
If this fundraiser is an event or activity that will be held on school property, please contact the Business Office to inquire about facility usage costs
that may be incurred with usage (580-221-3001 Ext 220). All applications for facility usage must be submitted at least 30 days prior to event.
Oves D.
Is this fund raiser a raffle?
D.
If yes, you must submit a request to the Board of Education asking for your specific raffle items to be approved prior to this being submitted to
the BOE for approval as required in Board Policy FG-B. Also see Administrative Procedure FG-B.1 for guidelines for raffles.
Sponsor' s Name
Princ1pai/Admin Name
Date Received by Supt Office
Superintendent:
L __ _ _ _ _ __ __
_Approved
_ _ _ _ ____,
Denied
_Approved
Denied
Date:
L __ _ _ _ _ _ _ _ _ ____,
Superintendent Signature
I
Oth"
Board Signature
'ti"
"'11'111
..~1.h.
:.,.
See attached catalogs.
~
Please review and select which option below describes your food fund raiser
D
My food items ARE NOT ready to consume-type items and can be sold during
the school day [12 a.m. to 4 p.m.]
D
My food items ARE ready to be consume-type AND I want to sell them du ring the
school day. [12 a.m. to 4 p.m.]
If this option is selected, the calculator tool is required to determine if your food items can
be approved. Please complete the calculator tool. If your items pass the calculator test,
please attach a copy of the test approval and a copy of the food label(s) to this fundraiser
request and submit to your principal for their approval and then to the Business Office. If
your food itern(s) do not pass the calculator test, then you will not be able to have the
fundraiser.
If this option is selected, no calculator too! is necessary.
Calculator tool : http://healthymeals.nal.usda.gov/s martsnacks
D
[{]
My fundraiser is a brochure or catalog and my items will not be released to
students until the end of the school day.
My food items ARE ready to consume-type items, however, I will not be
selling them during the school day [12 a.m. to 4 p.m.]
If this option is selected, no calculator tool is necessary.
My signature below affirms my choice of:
D
Optionl
I further agree to abide by the federal regulatio
~~/
l&11- QAk ~ -
~--....-~-------
Sponsor
-
Ooption3
Request for Fundraiser
School Year: _2_0_1_5-_2_0_16_
I
Date of Fundraiser: ____
N_ov_e_m_b_e_r_2_01_5_ __
Equipment, Meals, and etc.
Will sell smoked hams to community at Thanksgiving time.
Is this fundra iser request to sell a food item?
D
No
JZI Yes
Proceed with Page 1 Only
t::::.
If yes, please complete this page & page two to determine
eligibility for food fund raiser.
Describe what expenditures you would have .with this
fund raiser? [Cost to purchase the product, cost to make the
product to sell, etc ... ]
Estimated Expenses
Cost of product
I $2,000
Estimated PROFIT
Is this fundraiser an eve nt or act ivity that will be held at a specific location?
t::::. If yes, where:
I $4,000
_0ves6
Ard more Baseball Field
If this fund raiser is an event or activity that will be held on school property, please contact the Business Office to inquire about facility usage costs
that may be incurred with usage (580-221-3001 Ext 220). All applications for facility usage must be submitted at least 30 days prior to event.
Ovest::::.
Is this fundraise r a raffle?
C::. If yes, you must submit a request to the Board of Education asking for your specific raffle items to be approved prior to this being submitted to
the BOE for approval as required in Board Policy FG-B. Also see Administrative Procedure FG-B.1 for guidelines for raffles.
Sponsor's Name
IQII.IYI®J/@ri!UIM!rrli
IQI!riQIM!iU!iJ1!§.@iii!ii
Josh Newbv
FOR CENTRAL OFFICE ADM INISTRATION O NLY
Date Received by Business Office
_'6_../_..l_..l_ _ _ _ _ _ _ _ __
._I
Date Received by Supt Office L - -- - - - - - - - - - - '
Superintendent:
_Approved
Denied
l ••••••••:~f·!fi~iiD!.Ii•~IJi~im•]mlt!!~ti~il~·l~~·········
Denied
_Approved
Date :
Superintendent Signature
I Otho"
Board Signature
•
~:;.g,g~}. ii!~.~--.J ~
1
6
.
Hams
Please review and select which option below describes your food fundraiser
My food items ARE NOT ready to consume-type items and can be sold during
the school day [12 a.m. to 4 p.m.]
D
My food items ARE ready to be consume-type AND I want to sell them during the
school day. [12 a.m. to 4 p.m.]
If this option is selected, the calculator tool is required to determine if your food items can
be approved . Please complete the calculator tool. If your items pass the calculator test,
please attach a copy of the test approval and a copy of the food label(s) to this fund raiser
request and submit to your principal for their approval and then to the Business Office. If
your food item(s) do not pass the calculator test, then you will not be able to have the
fundraiser.
If this option is selected, no calcu lator tool is necessary.
Calculator tool: http://healthymeals.nal.usda.gov/smartsnacks
~
My food items ARE ready to consume-type items, however, I will not be
selling them during the school day [12 a.m. to 4 p.m.]
D
My fund raiser is a brochure or catalog and my items will not be released to
students until the end of the school day.
If this option is selected, no calculator tool is necessary.
Q~ ;a_og·o
My signature below affirms my choice of:
~
~
D Optionl D Option 2
It1' IOption 3
D
Option 4
by the ...... , .... ,..,._n_s_w-it_h._m_m_y_c_h_o-se_n_o_p_t-io_n_._ _ _ _ _ _ _ _ _ _ _ __
P•indpal
Request for Fundraiser
School Year: _ _1_5_-1_6_ _
Date of Fundraiser: _ _s_e..:..p_t_9,'-1_8..:..,_2_5_o_c_t_9,'-2_3_ _
Raise Funds for the Class of 2017
Worlds Finest Chocolate bars to be sold at football games along side the beef jerky
Is this fundraiser request to sell a food item?
D
No
Eves 6
Proceed with Page 1 Only
If yes, please complete this page & page two to determine
eligibility for food fundraiser.
Describe what expenditures you would have with this
fundraiser? [Cost to purchase the product, cost to make the
product to sell, etc ... ]
Estimated Expenses
cost of the chocolate
15 cases to be ordered
I $500
Estimated PROFIT
Is this fundraiser an event or activity that will be held at a specific location?
I $300
~No
Oves6
6 If yes, where :
If this fund raiser is an event or activity that will be held on school property, please contact the Business Office to inquire about facility usage costs
that may be incurred with usage (580-221-3001 Ext 220). All applications for facility usage must be submitted at least 30 days prior to event.
Is this fundraiser a raffle?
0ves6
6 If yes, you must submit a request to the Board of Education asking for your specific raffle items to be approved prior to this being submitted to
the BOE for approval as required in Board Policy FG -B. Also see Administrative Procedure FG-B.1 for guidelines for raffles.
Sponsor's Name
Principal/Admin Name
Date Received by Supt Office ' - - - - - - - - - - - - - - - - - '
Superintendent:
_Approved
Denied
_
Approved
Denied
Date:
'--------------~
Superintendent Signature
Other:
Board Signature
~
8
-
assorted chocolate bars
Please review and select which option below describes your food fundraiser
My food items ARE NOT ready to consume-type items and can be so ld du ri ng
t he school day [12 a.m. to 4 p.m.]
D
My food items ARE ready to be consume-type AND I want to sell them during the
school day. [12 a.m. to 4 p.m.]
If this option is selected, the calculator tool is required to determine if your food items can
be approved. Please complete the calculator tooL If your items pass the calculator test,
please attach a copy of the test approval and a copy of the food label(s) to this fund raiser
request and submit to your principal for their approval and then to the Business Office. If
your food item(s) do not pass the calculator test, then you will not be able to have the
fund raiser.
If this option is selected, no calculator tool is necessary.
Calculator tool: http://healthymeals.nal.usda.gov/smartsnacks
D
My food items ARE ready to consume-type items, however, I will not be
selling them during the school day [12 a.m. to 4 p.m.)
My fund raiser is a brochure or catalog and my items will not be released to
students until the end of the school day.
If this option is selected, no calculator tool is necessary.
7Z
w~"···
<=
Sponsor
. ,..
My signature below affirms my choice of:
D
Optionl
D
to ab;de by the ••••, •• •egulatlon
Option 2
-
D
Option 3
D
:'·=··~
Option 4
~~~--------------------~~--------------
Request for Fundraiser
School Year: _ _1_5_-1_6_ _
Date of Fundra iser: _ _s_e...;..p_t_9,_1_8_,_2_5_o_c_t_9,_2_3__
Raise Funds for the Class of 2017
Description of Fundraiser:
Beef Jerky from Country Meats to be sold along side the Chocolate
Is this fundraiser request to sell a food item?
0
No
Eves t:::.
Proceed with Page 1 Only
If yes, please complete this page & page two to determine
eligibility for food fundraiser.
Describe what expenditures you would have with this
fund raiser? [Cost to purchase the product, cost to make the
product to sell, etc ... ]
Estimated Expenses
cost of the Jerkey
12 cases to be ordered
I $1000
Estimated PROFIT
Is this fundraiser an event or activity that will be held at a specific location?
I $500
~No
Ovest::J.
t:::. If yes, where :
If this fundraiser is an event or activity that will be held on school property, please contact the Business Office to inquire about facility usage costs
that may be incurred with usage {580-221-3001 Ext 220) . All applications for facility usage must be submitted at least 30 days prior to event.
0vest::J.
Is this fund raiser a raffle?
C:::. If yes, you must submit a request to the Board of Education asking for your specific raffle items to be approved prior to this being submitted to
the BOE for approval as required in Board Policy FG -B. Also see Administrative Procedure FG -B.1 for guidelines for raffles.
Sponsor's Name
Principal/Admin Name
FOR CENTRAL OFFICE ADMINISTRATIO
Date Received by Business Office
1'-------------········II:Di•~fi~i;D!tii•DIIi]#•DIDII!i;!Smil~·l~~········
_Approved
Date Received by Supt Office
Superintendent:
_Approved
Denied
Denied
Date:
Superintendent Signature
Other:
Board Signature
List in detail the food
items you are proposing:
assorted prepackaged beef jerkey
Please review and select which option below describes your food fund raiser
D
My food items ARE NOT ready to consume-type items and can be sold during
the school day [12 a.m. to 4 p.m.)
D
If this option is selected, no calculator tool is necessary.
My food items ARE ready to be consume-type AND I want to sell them during the
school day. [12 a.m . to 4 p.m.)
If this option is selected, the calculator tool is required to determine if your food items can
be approved. Please complete the calculator tool. If your items pass the calculator test,
please attach a copy of the test approval and a copy of the food label(s) to this fundraiser
request and submit to your principal for their approval and then to the Business Office. If
your food item(s) do not pass the calculator test, then you will not be able to have the
fundraiser.
Calculator t ool : http://healthymeals.nal.usda.gov/smartsnacks
~
D
My food items ARE ready to consume-type items, however, I will not be
selling them during the school day [12 a.m. to 4 p.m.]
My fundraiser is a brochure or catalog and my items will not be released to
students until the end of the school day.
If this option is selected, no calculator tool is necessary.
My signature below affirms my choice of:
D
Optionl
D
Option 2
I further agree to abide by the federal regulations within
Sponsor
IV I
Option 3
D
Option 4
Request for Fundraiser
School Year: _ _1_5_-1_6_ _
I
Date of Fundraiser: _____s_e'-pt_1_-_16_ _ __
Description of Fund raiser:
Sell sausage, bacon, and chicken
B
~
No
~~ Yes6
Is this fundraiser request to sell a food ite' -
Proceed with Page 1 Only
If yes, please complete this page & page two to determine
eligibility for food fundraiser.
Describe what expenditures you would have with this
fund raiser? [Cost to purchase the product, cost to make the
product to sell, etc ... ]
Estimated Expenses
cost of the sasuage, bacon, and chicken
I $3000.00
Estimated PROFIT
Is this fund raiser an event or activity that will be held at a specific location?
D.
I $1800.00
~No
Oves6
If yes, where:
If this fund raiser is an event or activity that will be held on school property, please contact the Business Office to inquire about facility usage costs
that may be incurred with usage (580-221-3001 Ext 220). All applications for facility usage must be submitted at least 30 days prior to event.
Is this fundraiser a raffle?
0ves6
D. If yes, you must submit a request to the Board of Education asking for your specific raffle items to be approved prior to this being submitted to
the BOE for approval as required in Board Policy FG-B. Also see Administrative Procedure FG-B.1 for guidelines for raffles.
Sponsor's Name
Pnncipai/Admin Name
FOR CENTRAL OFFICE ADMINISTRATION 0
Date Received by Supt Office
Superintendent:
c___ _ _ _ _ _ _ __ __ _ ,
_Approved
Denied
_Approved
Denied
Date:
c___ _ _ _ _ _ _ _ _ ____,
Superintendent Signature
Other:
Board Signature
.
List in detail the food
items you are proposing:
..
Raw sausage, bacon, and chicken
Please review and select which option below describes your food fund raiser
~
D
My food items ARE NOT ready to consume-type items and can be sold during
the school day [12 a.m. to 4 p.m.)
If this option is selected, no calculator tool is necessary.
My food items ARE ready to be consume-type AND I want to sell them during the
school day. [12 a.m. to 4 p.m.]
If this option is selected, the calculator tool is required to determine if your food items can
be approved. Please complete the calculator tool. If your items pass the calculator test,
please attach a copy of the test approval and a copy of the food label(s) to this fundraiser
request and submit to your principal for their approval and then to the Business Office. If
your food item(s) do not pass the calculator test, then you will not be able to have the
fundraiser.
Calculator tool: http://healthymeals.nal.usda.gov/smartsnacks
D
D
My food items ARE ready to consume-type items, however, I will not be
selling them during the school day [12 a.m. to 4 p.m.]
My fund raiser is a brochure or catalog and my items will not be released to
students until the end of the school day.
If this option is selected, no calculator tool is necessary.
My signature below affirms my choice of:
/ZJIJ~
Sponsor
lv I
option 1
D
I further agree to abide by the federal regulations
Option 2
D
Option 3
y chosen option.
D
Option 4
Request for Fund raiser
School Year: _ _1_5_-1_6_ _
I
Date of Fundraiser: _____
N_ov_16_-_2_7_ _ __
Description of Fund raiser:
Sell sausage, bacon, and chicken
Is this fund raiser request to sell a food item L
~No
'7J:fi
Yes
Proceed with Page 1 Only
6
Describe what expenditures you would have with this
fund raiser? [Cost to purchase the product, cost to make the
product to sell, etc .. .]
Estimated Expenses
If yes, please complete this page & page two to determine
eligibility for food fundraiser.
cost of the sasuage, bacon, and chicken
I $1500
Estimated PROFIT
Is this fundraiser an event or activity that will be held at a specific location?
I $900
~No
Oves6
6 If yes, where :
If this fundraiser is an event or activity that will be held on school property, please contact the Business Office to inquire about facility usage costs
that may be incurred with usage (580-221-3001 Ext 220) . All applications for facility usage must be submitted at least 30 days prior to event.
Is this fund raiser a raffle?
0ves 6
6 If yes, you must submit a request to the Board of Education asking for your specific raffle items to be approved prior to this being submitted to
the BOE for approval as required in Board Policy FG-B. Also see Administrative Procedure FG-B.1 for guidelines for raffles.
Sponsor's Name
Pnnc1pai/Admin Name
Robert McGehee
....
Jake Falvev
FOR CENTRAL OFFICE ADMINISTRATION ONL
Date Received by Supt Office '----- - - - - - - - - - - - - - '
Superintendent:
_Approved
Denied
_Approve d
Denied
Date: L - - - - - - - - - - - - - - '
Superintendent Signature
Other:
Board Signature
~:~,2--.J
List in detail the food
items you are proposing:
Raw sausage, bacon , and chicken
Please review and select which option below describes your food fund raiser
D
My food items ARE NOT ready to consume-type items and can be sold during
the school day [12 a.m . to 4 p.m .]
My food items ARE ready to be consume -type AND I want to sell them during the
school day. [12 a.m. to 4 p.m.]
If this option is selected, the calculator tool is required to determine if your food items can
be approved. Please complete the calcu lator tool. If your items pass the calculator test,
please attach a copy of the test approval and a copy of the food label(s) to this fundraiser
request and submit to your principal for their approval and then to the Business Office. If
your food item(s) do not pass the calculator test, then you will not be able to have the
fundraiser.
If this option is selected, no calculator tool is necessary.
Calculator tool: http://healthymeals.nal.usda.gov/smartsnacks
D
D
My food items ARE ready to consume-type items, however, I will not be
selling them during the school day [12 a.m. to 4 p.m.]
My fund ra iser is a brochure or catalog and my items will not be released to
students until the end of the school day.
If this option is selected, no calculator tool is necessary.
?
My signature below affirms my choice of:
Ill' I
D
Option 2
&_~~rthe< ••••• to •bide by the fede"l <egul•tlon• wlf .
~~~,Sponsor
option 1
D
Option 3
D
Option 4
chosen option.
dJ _ ..-c.
~
Request for Fund raiser
School Year: _ _1_5_-1_6_ _
I
Date of Fundraiser: _ _ _ _M_a_rc_h_2_1_-_31_ _ __
Description of Fundraiser:
Sell sausage, bacon, and chicken
Is this fund raiser request to sell a food item'?\.
_ ~No
~ Vest:::.
Proceed with Page 1 Only
If yes, please complete this page & page two to determine
eligibility for food fundraiser.
Describe what expenditures you would have with this
cost of the sasuage, bacon, and chicken
fundraiser? [Cost to purchase the product, cost to make the
product to sell, etc ... ]
Estimated Expenses
I $2000
Estimated PROFIT
Is this fund raiser an event or activity that will be held at a specific location?
I $1000
~No
Ovest:::.
t:::. if yes, where :
If this fund raiser is an event or activity that will be held on school property, please contact the Business Office to inquire about facility usage costs
that may be incurred with usage (580-221-3001 Ext 220) . All applications for facility usage must be submitted at least 30 days prior to event.
Is this fund raiser a raffle?
0ves6
C::. If yes, you must submit a request to the Board of Education asking for your specific raffle items to be approved prior to this being submitted to
the BOE for approval as required in Board Policy FG -B. Also see Administrative Procedure FG -B.1 for guidelines for raffles.
Sponsor's Name
Principal/Admin Name
FOR CENTRAL OFFICE ADMINISTRATION
Date Received by Supt Office '------------___.J
Superintendent :
_Approved
Denied
_Approved
Denied
Date: ' - - - - - - - - - - - - - - - '
Superintendent Signature
Other:
Board Signature
List in detail the food
items you are proposing:
Raw sausage, bacon, and chicken
Please review and select which option below describes your food fundraiser
~
D
My food items ARE NOT ready to consume-type items and can be sold during
the school day [12 a.m. to 4 p.m.]
If this option is selected, no calculator tool is necessary.
My food items ARE ready to be consume-type AND I want to sell them during the
school day. [12 a.m. to 4 p.m.]
If this option is selected, the calculator tool is required to determine if your food items can
be approved. Please complete the calculator tool. If your items pass the calculator test,
please attach a copy of the test approval and a copy of the food label(s) to this fundraiser
request and submit to your principal for their approval and then to the Business Office. If
your food item(s) do not pass the calculator test, then you will not be able to have the
fundraiser.
Calculator tool : http://healthymeals.nal.usda .gov/smartsnacks
D
D
My food items ARE ready to consume-type items, however, I will not be
selling them during the school day [12 a.m. to 4 p.m.]
My fundraiser is a brochure or catalog and my items will not be released to
students until the end of the school day.
If this option is selected, no calculator tool is necessary.
My signature below affirms my choice of:
;;:::>// ~
S~~-
IV IOption 1 D Option 2 D Option 3 D Option 4
11"rthe' ag'ee to abide by the 1
~e,alre~
~
chosen option.
Request for Fundraiser
School Year: _ _1_5_-1_6_ _
I
Date of Fundraiser: _ _
se""""p_t_1-'1,_1_8'-,2_5_0_c_t_9'-,2_3__
Tailgate for Football
Description of Fundraiser:
Sell hamburgers, hotdogs, chips, dessert, and drinks before the games
Is this fundraiser request to sell a food item?
D
No
Eves 6
Proceed with Page 1 Only
If yes, please complete this page & page two to determine
eligibility for food fund raiser.
Describe what expenditures you would have with this
fund raiser? [Cost to purchase the product, cost to make the
product to sell, etc .. .]
Estimated Expenses
Cost of items required for each tailgate . udgeted
for $200 per game asking for donations
I $1000
Estimated PROFIT
Is this fundraiser an event or activity that will be held at a specific location?
6 If yes, where : Football
I $1000
0.ves 6
Field ParkinQ Lot
If this fund raiser is an event or activity that will be held on school property, please contact the Business Office to inquire about facility usage costs
that may be incurred with usage (580-221-3001 Ext 220}. All applications for facility usage must be submitted at least 30 days prior to event.
Is this fundraiser a raffle?
0ves6
6 If yes, you must submit a request to the Board of Education asking for your specific raffle items to be approved prior to this being submitted to
the BOE for approval as required in Board Policy FG-B. Also see Administrative Procedure FG-B.1 for guidelines for raffles.
Sponsor's Name
Principal/ Admin Name
FOR CENTRAL OFFICE ADMINISTRATION
Date Received by Business Office
IL____________ ••••••••[:tri!e~f·~m!:•ill•!l:IJI4!!•!l!ll!l!f!!l·SI]i~!t!!lN!II·······
Date Received by Supt Office L - - - - - -- - - - --'
Superintendent :
_Approved
Denied
_Approved
Denied
Date :
Superintendent Signature
Board Signature
~~i£~
List in detail the food
items you are proposing:
I
ssg
~:~,~----..J
I
~
Hamburgers, hot dogs, chips, desserts, drinks
Please review and select which option below describes your food fund raiser
D
My food items ARE NOT ready to consume-type items and can be sold during
the school day [12 a.m. to 4 p.m .]
D
My food items ARE ready to be consume-type AND I want to sell them during the
school day. [12 a.m. to 4 p.m.]
If this option is selected, no calculator tool is necessary.
If this option is selected, the calculator tool is required to determine if your food items can
be approved. Please complete the calculator tool. If your items pass the calculator test,
please attach a copy of the test approval and a copy of the food label(s) to this fundraiser
request and submit to your principal for their approval and then to the Business Office. If
your food item(s) do not pass the calculator test, then you will not be able to have the
fundraiser.
Calculator tool : http://healthymeals.nal.usda.gov/smartsnacks
~
D
My food items ARE ready to consume-type items, however, I will not be
selling them during the school day [12 a.m . to 4 p.m.]
My fund raiser is a brochure or catalog and my items will not be released to
students until the end of the school day.
If this option is selected, no calculator tool is necessary.
My signature below affirms my choice of:
D
Optionl
D
Option 2
Ill' I
Option 3
D
Option 4
I further agree to abide by the federal regulatio.,IB withil\my chosen option~
~c::~ ""--- -~
Sponsor
~~
Request for Fund raiser
Date of Fundraiser: ___s_ch_o_o_ly'-e_a_r_20_1_5_-2_0_1_6_ __
School Year: __2_0_15_-2_0_1_6_
sgs
1
1
Wtq§.!II,II~Mfti.I§M
To sell food products from Fundrai sing.com that meet the healthy food guidelines
and to sell pencils and bottled water.
To provide funds for the ACS Elementary Music at each elementary site
Description of Fundraiser:
The music directors at each school will sell healthy food snacks, pencils and bottled water during the school day for the year
Is this fundraiser request to sell a food item?
D
No
IZi ves
Proceed with Page 1 Only
C::.
If yes, please complete this page & page two to determine
eligibility for food fundraiser.
Describe what expenditures you would have with this
fundraiser? [Cost to purchase the product, cost to make the
product to sell, etc ... ]
Estimated Expenses
Pencils will sell for .25 each (profit = .11)
Bottled water $1 (profit .80)
Beef Jerky $2 (profit .4 7)
I $ o.oo
Estimated PROFIT
Is this fundraiser an event or activity that will be held at a specific location?
C::. if yes, where :
I $ 6000.oo
0ves C::.
at each elementary site
If this fundraiser is an event or activity that will be held on sc hool property, please contact the Business Office to inquire about facility usage costs
that may be incurred with usage (580-221-3 001 Ext 220). All applications for f acility usage must be submitted at lea st 30 days prior to event.
Oves C::.
Is this fundraiser a raffle?
C::. If yes, you must submit a request to the Board of Education asking for your specific raffle items to be approved prior to this being submitted to
the BOE for approval as required in Board Policy FG -B. Also see Administrative Procedure FG -B.1 for guidelines for raffles .
IQiu!§I!WunuiMJu!l
FOR CENTRAL OFFICE ADMINISTRATION ONLY
Date Received by Business Office ...-r.raJ(~~
_Approved
Date Received by Supt Office
Superintendent:
_Approved
BOARD OF EDUCATION
Denied
Denied
Date:
Superintendent Signature
Other:
Board Signature
ACS Elementary Music
Charles Evans, Lincoln , Jefferson
·f#iMJMii.ti!,li~@J.,i-
list in detail the food
items you are proposing:
Jack Links beef Jerky, bottled water
Please review and select which option below describes your food fundraiser
D
OPTION2
OPTION 1
My food items ARE NOT ready to consume-type items and can be sold during
the school day [12 a.m. to 4 p.m.]
My food items ARE ready to be consume-type AND I want to sell them during the
schoo l day. [12 a.m. to 4 p.m.]
If th1s option is selec.ted, no caitulator tool J.S necessarv.
It ltus oplion ~~ ~e!e c. ted, the calculator tool is required to determme if yo ur f ood it erns can
be approved. Please rornplete the calculator tool. If your Jtems pass the calculator test,
ple~s\~ attach a copv of the test approval and a copy of the food label(s) to this fu ndrais e r
rt•qut:~t
and submi t to your pr1nc.ipal for their approval and then to the Business Office. If
w•\1 not be able t o ha ve the
fundrai::.er
v0ur food 11t.•m1:.) dn not pass the calr.ulator test, then you
Calculator t ool: b.!!QJLhea lt hymea ls. nal .usda.govJsm art sn acks
D
D
OPTION 3
My food items ARE ready t o consume-type items, however, I will not be
selling them during the schoo l day [12 a.m. to 4 p.m.]
OPTION4
My fundrai ser is a brochure or catalog and my items will not be released to
stud ents until th e end of th e scho ol day.
If thi'i option is selected, no co!culator tool is necessary.
My signature below affirms my choice of:
D
Optionl
[{]Option 2
..
Pnncopa
D
Option 3
D
Option 4
,~
Fundraiser Exemption
~· n ~
Signature: ~\ ll ~ U
Sponsor
Principal
Date
D I\
(,
\L · UMJI\~
.-t_
~ e ku,-x=<.
Signature:
n3j fO} }
Approved:
l_ of
14
30
Spring 2015
1
~ii:Al11-iiE1t U,
GENERI\TIO~ • 't
Smart Snacks
Product Calculator Results
Nutrition Facts
Serving Size 0.85 oz (about 24.10 g) 0
Brand:
Jack Link's
Product Name:
Original Beef Jerky
Serving Size:
24.10 g
First Ingredient:
Beef
Amount Per Serving
Calories from Fat 10
Calories 70
Total Fat (g) 1
Saturated Fat (g) 0
Trans Fat (g) 0
Sodium (mg) 200
Carbohydrates
Sugars (g) 6
• Your protein food meets all nutrient standards.
ol
Vitamin D (%) NA
Potassium (%) NA
Calcium (%) NA
Dietary Fiber(%) NA
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1/22/2015
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GENERATION
1 Smart Snacks
I
Product Calculator Results
t
Brand:
Jack Link's
I
'
-··
Nutrition Facts
Serving Size 0.85 oz (about 24.10 g) 0
Product Name:
Teriyaki Beef Jerky
Serving Size:
24.10 g
First Ingredient:
Beef
Amount Per Serving
Calories 90
Calories from Fat 10
Total Fat (g) 1
Saturated Fat (g) 0
Trans Fat (g) 0
Sodium (mg) 200
Carbohydrates
Sugars (g) 6
• Your protein food meets all nutrient standards.
Vitamin D (%) NA
Potassium (%) NA
Calcium (%) NA
Dietary Fiber(%} NA
0
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.SMi\W SNI\C"";KS
tm I'I~OUIJU CALCULMOf?
Smart Snacks
Product Calculator Results
Nutrition Facts
Serving Size 0.85 oz (about 24.10 g) 0
Brand:
Jack Link's
Product Name:
Peppered Beef Jerky
Serving Size: .
24.10 g
First Ingredient:.
Beef
·
·
Amount Per Serving
Calories 70
Calories from Fat 10
Total Fat (g)1
Satu~ated
Fat (g) 0
Trans Fat (g) 0
Sodium ("'g) 190 .
Carbohydrates
Sugars (g) 6
• Your protein food meets all nutrient standards.
Vitamin D (%) NA
Potassium (%) NA
Calcium (%) NA
Dietary Fiber (%) NA
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J1ACK LI.NK'S
BEEF" .JERKY
Orjgjnal
INGREDIENTS: BEEF, SUGAR, WATER, LESS THAN 2%
SALT, FLAVORING, YEAST EXTRACT, CITRIC ACID.
.85oz Beef Jerky
Terjya.ki
Peppered
INGREDIENTS: BEEF, SUGAR, WATER, LESS THAN 2%
SALT, FLAVORING, DRIED SOY SAUCE [(WHEAT,
SOYBEANS, SALT), MALTODEXTRIN], YEAST EXTRACT,
CITRIC ACID.
CONTAINS: WHEAT AND SOY
INGREDIENTS: BEEF, SUGAR, WATER, LESS THAN 2%
BLACK PEPPER, SALT, FLAVORING, YEAST EXTRACT,
CITRIC ACID.
··
fin~
lOg
Protein
·l'!llwfiil Ut1l
10000007721 .85 oz. Original Beef Jerky
10000007717 .85 oz. Teriyaki Beef Jerky
10000007719 .85 oz. Peppered Beef Jerky
Open Stock Case: 48 units per case
lg Total Fat
Request for Fund raiser
School Year: _ _20_1_5_11_6_ _
Date of Fundraiser: ____N_o_ve_m_b_e_r_2_01_5_ _ __
AHS Forensics Booster Club
li!.jjhllli!iill·J
Description of Fund raiser:
Smoked Ham and Turkeys
Is this fundraiser request to sell a food item?
D
No
IZI Yes
D.
Describe what expenditures you would have with this
fundraiser? [Cost to purchase the product, cost to make the
product to sell, etc ...]
Estimated Expenses
Proceed with Page 1 Only
If yes, please complete this page & page two to determine
eligibility for food fund raiser.
Pre-sell Smoked Hams and Turkeys for delivery
for Thanksgiving.
I $120o.oo
Estimated PROFIT
Is this fund raiser an event or activity that will be held at a specific location?
D. If yes, where :
I $ 350o.oo
Oves D.
If this fundraiser is an event or activity that will be held on school property, please contact the Business Office to inquire about facility usage costs
that may be incurred with usage (580-221-3001 Ext 220). All applications for facility usage must be submitted at least 30 days prior to event.
Oves D.
Is this fund raiser a raffle?
D.
If yes, you must submit a request to the Board of Education asking for your specific raffle items to be approved prior to this being submitted to
the BOE for approval as required in Board Policy FG-B. Also see Administrative Procedure FG-B.1 for guidelines for raffles.
Sponsor's Name
Pnnc1pai/Adm1n Name
Date Received by Supt Office
Superintendent:
_
_Approved
Approved
Denied
Denied
Date:
Superintendent Signature
Board Signature
······A·H·S·IFioll~leB£m~~i~.f~;:~.!l l~ ~f~ ?~u:~~-tle.r1c.l1u·b······' '•·Miii.!i~!lf il.l§
list in detail the food
1tems you are proposing
AHS
School Site
Purchase Hams and Turkeys and smoke them to fill orders. Deliver before Thanksgiving.
Please review and select which option below describes your food fund raiser
D
OPTION 1
My food items ARE NOT ready to consume-type items and can be sold during
the school day [12 a.m. to 4 p.m.]
D
OPTION 2
My food items ARE ready to be consume-type AND I want to sell them during the
school day. [12 a.m . to 4 p.m.]
If tt11s option is selected. the calculator tool is required to determine if your food items can
If ttus option is selected. no calculator tool1s necessary.
be approved. Please complete the calculator tool. It your items pass the calculator test.
please attach a copy of the test approval and a copy of the food label(s) to thiS fundraiser
reque~t and submit to your principal for the1r approval and then to the Bus mess Off1ce. If
your food item(s} do not pa.o;s the calculator test. then you will not be able to have the
fund raiser.
Calculator tool: http://hea IthymeaIs. naI. usda .gov/smartsnacks
D
OPTION 3
OPTION4
My food items ARE ready to consume-type items, however, I will not be
selling them during the school day [12 a.m. to 4 p.m.]
My fund raiser is a brochure or catalog and my items will not be released to
students until the end of the school day.
If th1!i option is selected, no calculator tool1s necessary.
My signature below affirms my choice of:
D
Option 1
D
Opti n 2
-~
I further agree to abide by the federal regulations with
{()(
[l] Optlon4