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Our school has a Crunch&Sip® Committee

Our school has a written Crunch&Sip® policy - please attach   Attachment:

Our Crunch&Sip® policy has been endorsed by the school community   Endorsed by:      Date endorsed:

Our school has identified ways to provide fruit or vegetables for students who do not have access to them

Students, teachers and parents have been made aware of Crunch&Sip® (must check at least three boxes):   Consulted during policy development Outlined in policy and procedures manual Provided information at enrolment Inserts in school newsletter/s Sent out parent brochure Sent letter to parents Presented to relevant school committees (eg. P&C) Presented at staff meetings

Most classrooms have designated Crunch&Sip® breaks (must be over 80%)   Total number of classrooms in the school Number of classrooms with a Crunch&Sip® break Percentage of classrooms with Crunch&Sip®

Most students participated in Crunch&Sip® over the last five days (must be over 70%)   Total number of students in the school Number of students participating Percentage of students participating in Crunch&Sip®

Please insert your school contact details for your Crunch&Sip® certification.   * Contact name: * School name: * School postal address: * School street address:

Contact details:   Telephone: Facsimile: Email: Website:

Please insert student numbers if you would like to receive Crunch&Sip® water bottles for each student: (only for participating classes)   Total number of students to receive Crunch&Sip® water bottles:

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