Summer Food Service Program (SFSP) Application


Neighborhood and Community Services

12011 Government Center Parkway, Tenth Floor
Fairfax, VA  22035-1115
Phone 703-324-4600, TTY 711
Fax 703-222-9792

To become a meal site, please fill-out the application below. Neighborhood and Community Services staff will send you an e-mail stating it has received your application. Approval of your application is determined by the United States Department of Agriculture (USDA). If you have any questions, please call 703-324-5330, TTY 711.

Site Name:

Site Address 1:

Site Address 2:

City: County: State: Zip Code:

Site Phone Number: Site Fax:

Delivery entrance number, if applicable (School Sites):


Administrative Contact Name:

Contact Title:

Contact Phone Number:  Contact Email:

Site Supervisor Contact Name:

Site Supervisor Title:

Site Phone Number: Site Email Address:


Would you like to participate as a "meal service" site? Yes No Maybe (Need Additional Information)

Indoor Outdoor


    End Date:  

Days of Operation (Please check box)

 Monday

 Tuesday

 Wednesday

 Thursday

 Friday

How many Days of the SFSP will you operate?  (Program closed Weekends and July 4th)

June:  

July:   

August:  

September:  

What is the closest Fairfax County Public School to your site?  

What is your type of site?  


Yes
 No

Reasonable accommodations will be made upon request. 703-324-5330, TTY 711.


Contact Fairfax County: Phone, Email or Twitter | Main Address: 12000 Government Center Parkway, Fairfax, VA 22035
Technical Questions: Web Administrator

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