1. Completing Your Application H EALTHIER US S CHOOL C HALLENGE Alicia Dill, RDN, CD, CDE Nutrition Education Consultant WI Department of Public Instruction – School Nutrition Team

2. A PPLICATION B ASICS  Separate 24-page application for bronze/silver and gold/gold of distinction  Application must be based on two-week period  Full weeks, no missing days  Same period for breakfast and lunch  Menus must have been served within the last 6 months  Submission of supporting documentation

3. S UPPORTING D OCUMENTATION  Team Nutrition verification  Wellness Policy  Menu (2 consecutive weeks)  Production records (not required for Bronze)  Whole grain-rich product documentation  CN labels for combination products (i.e., pizza)  6-cent certification menu worksheet (lunch)  2 consecutive weeks  No nutrient analysis required

4. M ULTI -S CHOOL D ISTRICT A PPLICATION  The same menu and foods served throughout the district  Same competitive foods and beverages were sold (cafeteria and/or school campus)  Same nutrition education and physical education is provided  Same physical activities are offered  All schools follow the district wellness policy Multiple schools can apply under a district application when:

5. M ULTI -S CHOOL D ISTRICT A PPLICATION  One set of consecutive two-week breakfast and lunch menus  One set of lunch Certification Worksheets for the two-week menu period  One set of breakfast and lunch whole grain documentation  One Competitive Foods Worksheet with a listing of foods available with supporting documentation  District Wellness Policy  District School List Form (http://healthymeals.nal.usda.gov/hsmrs/HUSSC/DistrictHUSS CSchoolListing.docx)http://healthymeals.nal.usda.gov/hsmrs/HUSSC/DistrictHUSS CSchoolListing.docx For all schools, district may submit:

6. M ULTI -S CHOOL D ISTRICT A PPLICATION  General Criteria Worksheet (pg 5)  School Wellness Policy Worksheet (application pg 18)  Other Criteria for Excellence Checklist (application pgs 19-21) For each individual school, district must submit:

7. HUSSC A PPLICATION  Application Cover Sheet (pg 3)  Select award level  Complete school/district information  Contact information for State follow-up questions

8. HUSSC A PPLICATION  General Criteria Worksheet (pg 5)  Must meet all general criteria prior to proceeding  Describe your meal service structure Example: we use offer vs. serve. Students are offered 1 main entrée, 2 vegetable choices, 2 fruit choices with one fresh fruit daily, and a choice of 1% white, fat-free white, and fat-free chocolate milk  List ADP percentage for breakfast and lunch and the month/year calculated

9. HUSSC A PPLICATION Breakfast and Lunch Menu Offerings (pg 6)  Includes information for what must be submitted along with application  Copies of menus  Copies of completed NSLP 6-cent certification menu worksheets (no simplified nutrient assessment required)  Production records (not required for bronze)  Whole grain-rich product documentation  CN labels for combination products (i.e., pizza)  Enter the service dates your application is based on

10. HUSSC A PPLICATION Grain Offerings: Breakfast (pg7) and Lunch (pg8)  Enter information under the “Week 1” or “Week 2” table  Include all grains served  Enter the specific dates each grain was served  Enter the specific grain information  Include an asterisk for all whole grain-rich items  Whole wheat waffles*  Hamburger bun  Brown rice*

11. HUSSC A PPLICATION Vegetable Subgroup Contributions (pgs 9-10)  Enter all vegetables offered each day and the serving size offered  Place an “x” to indicate subgroup  Indicate total vegetables offered during one day in the “Total” line  Use additional pages if more than three vegetables offered each day  Place an asterisk next to vegetables that are contributing to the “additional” vegetables to meet HUSSC requirements

12. HUSSC A PPLICATION Fruit Variety(pgs 11-12)  Enter the name of the fruit served on the appropriate day/week line  Enter the creditable serving size (drop-down box)  If you offer a choice, only enter one fruit for each day  For gold/gold of distinction a different fruit must be entered every day  Note variations of a fruit are considered to be the same  Ex: apples and applesauce are both considered “apples” Sample Lunch Fruit Menu Apple Pears Orange Peaches Kiwi Pineapple Grapes Applesauce Banana Mandarin Oranges

13. HUSSC A PPLICATION Nutrition Education Worksheet(pg 13)  If you have received the Healthy School Program Award in the past year, you do not need to complete this section  Nutrition education must be provided to  all elementary student children  at least two middle school grades  At least two high school classes  Specify the grade levels and describe your nutrition education practices  Include how nutrition education is delivered (classroom instruction, cafeteria taste tests, parental mailings, etc)

14. HUSSC A PPLICATION Physical Education Worksheet(pg 14-15)  If you have received the Healthy School Program Award in the past year, you do not need to complete this section  Physical education must be provided to  all elementary student children  at least two middle school grades  At least two high school classes  Specify the grade levels and describe your physical education practices  Specify the number of minutes/week PE is provided for elementary school grade levels

15. HUSSC A PPLICATION Physical Activity (PA) Worksheet(pg 16)  If you have received the Healthy School Program Award in the past year, you do not need to complete this section  Describe all types of PA opportunities offered  Include the time allotted for PA  Activities listed under the physical education section may not be included  Describe how the school actively promotes participation in PA

16. HUSSC A PPLICATION Competitive Foods Worksheet(pg 17)  Competitive foods must be entered if the foods are served:  In the foodservice area during meal periods (bronze/silver)  Anywhere in the school at any time during the day (gold/gold of distinction)  You must use the Competitive Foods Calculator if your school offers:  A la carte options  Second servings of any foods not part of the reimbursable lunch meal  Vending machines  School store snacks

17. C OMPETITIVE F OODS C ALCULATOR  Found at http://healthymeals.nal.usda.gov/ hsmrs/HUSSC/calculator.html http://healthymeals.nal.usda.gov/ hsmrs/HUSSC/calculator.html  Do not use for beverages  Allows you to select school type and award level  Required to analyze every competitive food offering and submit results

18. C OMPETITIVE F OODS C ALCULATOR 1. Enter your school name 2. Enter the name of the product 3. Click “Add to List” button *You will not be able to enter nutrition facts information until the item has been added to the list*

19. C OMPETITIVE F OODS C ALCULATOR 4. Enter the nutrition facts of your food 5. Only enter the sodium information for the side dish/snack or the entrée 6. Press “Calculate” to see if your item meets competitive foods criteria 7. Check acceptability of competitive food (Acceptable food items will be added to the list with the word “Yes”)

20. C OMPETITIVE F OODS C ALCULATOR  If an item does not meet the HUSSC competitive food standards you will see the problem nutrients  Double check that correct information was entered and correct the nutrient facts as needed  Delete item from list  Enter product name and add to list  Enter correct nutrient information and “calculate”  If item is unacceptable by HUSSC standards, the item must be removed from sales in order qualify for HUSSC certification

21. HUSSC A PPLICATION Competitive Foods Worksheet Continued(pg 17)  Print a copy of the competitive foods calculator results for submission  All competitive foods product labels must be submitted  Recipes must be submitted for school-made products (i.e. baked goods)  Fundraising items sold during the school day must meet the guidelines for competitive foods

22. HUSSC A PPLICATION School Wellness Policy Worksheet(pg 18)  Describe:  Activities in place to meet wellness goals  School and community involvement in wellness policy implementation  If wellness practices are stricter than policy  School’s commitment to neither denying nor requiring physical activity as punishment  School’s commitment to prohibiting food as a reward  Submit a copy of your school or district wellness policy

23. HUSSC A PPLICATION Other Criteria for Excellence Checklist (pgs 19-21)  School may select from any option listed and provide a brief description  Submit the supporting documentation for each option as applicable  To qualify for the HUSSC award, select:  2 out of 20 options for bronze  4 out of 20 options for silver  6 out of 20 options for gold  8 out of 20 for gold of distinction

24. HUSSC A PPLICATION Review Committee Verification Form (pgs 22-23)  Separate forms for individual school application and school district application  All listed parties must sign the form  Individuals are agreeing and attesting that:  Information is accurate  School meals are healthy  Healthy practices will be maintained for the length of certification status  School will work with USDA to publicize efforts

25. HUSSC A PPLICATION Application Check-off Sheet (pg 24)  School should double check all items listed have been completed  Copies of all specified materials must be submitted  WI DPI - SNT reviews and submits to USDA – Midwest Regional Office  School may be contacted with questions by SNT staff  WI DPI may certify, but USDA may have additional questions  If errors are found or materials are missing, USDA may be down-grade application

26. T ECHNICAL A SSISTANCE  DPI-SNT is happy to help you complete your application  Please contact: Alicia Dill, RDN, CD, CDE at alicia.dill@dpi.wi.gov or (608)266-2741alicia.dill@dpi.wi.gov or Kelly Williams, RDN,CD at kelly.williams@dpi.wi.gov or (608)267-9120kelly.williams@dpi.wi.gov

27. The U.S Department of Agriculture prohibits discrimination against its customers, employees, and applicants for employment on the bases of race, color, national origin, age, disability, sex, gender identity, religion, reprisal, and where applicable, political beliefs, marital status, familial or parental status, sexual orientation, or all or part of an individual’s income is derived from any public assistance program, or protected genetic information in employment or in any program or activity conducted or funded by the Department. (Not all prohibited bases will apply to all programs and/or employment activities.) If you wish to file a Civil Rights program complaint of discrimination, complete the USDA Program Discrimination Complaint Form, found online at http://www.ascr.usda.gov/complaint_filing_cust.html, or at any USDA office, or call (866) 632-9992 to request the form. You may also write a letter containing all of the information requested in the form. Send your completed complaint form or letter to us by mail at U.S. Department of Agriculture, Director, Office of Adjudication, 1400 Independence Avenue, S.W., Washington, D.C. 20250-9410, by fax (202) 690-7442 or email at program.intake@usda.gov.USDA Program Discrimination Complaint Formhttp://www.ascr.usda.gov/complaint_filing_cust.html program.intake@usda.gov Individuals who are deaf, hard of hearing or have speech disabilities may contact USDA through the Federal Relay Service at (800) 877-8339; or (800) 845-6136 (Spanish). USDA is an equal opportunity provider and employer.