Healthy School Team Reporting Form

The Healthy School Team Reporting Form is to be completed annually, by each school site, no later than the end of September.
The Healthy School Team should consist of: parents, students, school food service program
representatives, school administrators, school health professionals, physical education teachers and the
public.
The Healthy School Team is responsible for:
• Ensuring compliance with state and federal rules involving competitive food and beverage items sold on a school campus;
• Maintaining a school calendar identifying the dates when exempted competitive food fundraisers will
occur in accordance with the limits defined by Florida rule.
• Reporting its school’s compliance with competitive food rules to the designated Local Educational Agency
(LEA) official or school official responsible for overall compliance with the local school wellness policy.

School
Healthy School Team Leader (Primary contact person) Healthy School Team Leader (Primary contact person) First Last
Healthy School Team Leader Email
Healthy School Team Leader job title
Healthy School Team meeting days
Are your Healthy School Team meetings in conjunction with your SAC meetings

Are your Healthy School Team meetings in conjunction with your SAC meetings Yes No
Healthy School Team Members

*HST members must include 5 out of the 7 below stakeholders:
**Please fill out all that apply
Parent (i.e. SAC Member) Parent (i.e. SAC Member) First Last
Student (i.e. SAC Member) Student (i.e. SAC Member) First Last
School food service representatives (i.e. Cafeteria Manager) School food service representatives (i.e. Cafeteria Manager) First Last
School administrators (i.e. SAC Member) School administrators (i.e. SAC Member) First Last
School health professionals (i.e. School Nurse, School Clinic Assistant) School health professionals (i.e. School Nurse, School Clinic Assistant) First Last
Physical education teachers Physical education teachers First Last
The Public/Community Partners (i.e. SAC Member)Healthy School Team Members The Public/Community Partners (i.e. SAC Member)Healthy School Team Members First Last
Where is your fundraiser calendar located on your school’s website?
Spam Protection. Please answer this simple question:
5, 6, 7, 8 : the 2nd number is?

Healthy School Team Reporting Form

Healthy School Team Reporting Form

Healthy School Team Members