Related Resources and Course Completion Form:

Missouri CSFP Course
(read-only version: no audio, can be downloaded and printed)

Course Completion Attestation
(online only, if showing video to a group please have each person complete and submit their form separately, thank you)

Questions? Please contact your Partner Relationship Coordinator.

The St. Louis Area Foodbank is an equal opportunity provider.
USDA Nondiscrimination Statement

Helpful forms:
Missouri CSFP Income Guidelines

Missouri CSFP Form
• FNS-191 Racial Ethnic Group Participation 
• Health & Social Services Referral Information (outreach – other assistance programs for seniors) 
• Monitoring Review – CSFP Distribution Sites (site inspector’s checklist)
• Notice of Adverse Action (Spanish and English) 
• Notice of Certification Status (Spanish and English)  
• One Month Certification and Sign In Sheet 
• Participant Application (Spanish and English)  
• Participant Waiting List 
• Proxy Authorization 
• Verification of Certification for Transfers

Neighbor sign-in sheet 
Temperature Log
Pest Control Log 

Posters/Flyers (display in clear view of the public and give to neighbors): 
• Appeal Process Information (Right to Fair Hearing)
• No-Show Policy poster
• Written Notice of Beneficiary Rights
• And Justice For All (contact your Partner Relationship Coordinator)