Do you know a school nutrition employee retiring this year? The Wisconsin Department of Public Instruction (DPI) School Nutrition Team (SNT) would like to recognize them for their many years of dedication and commitment to the health and nutritional well-being of the students they serve. Please complete this form and a certificate will be mailed in 5-10 business days. Requestor Info First Name * Last Name * Email * Retiree Info First Name * Last Name * Credentials, if applicable (e.g., RDN, CD, SNS) School Food Authority Name(s) Total years of service to the school meal programs Date of Retirement Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year20222023202420252026 Where and to whom should the certificate be mailed? Where is it being sent Retiree Requestor Other First Name * Last Name * School Food Authority Name (if applicable) * Mailing Address City State Zip Do you have any other questions or comments? Leave this field blank Submit
