Food Service Public Release

HOW TO APPLY FOR FREE AND REDUCED PRICE SCHOOL MEALSPlease use these instructions to help you fill out the application for free or reduced price school meals. You only need to submit one application per household, even if your childrenattend more than one school in The application must be filled out completely to determine the eligibility your child(ren) for free or reduced price schoolmeals.

Please follow these instructions in order! Each step of the instructions is the same as the steps on your application. If at any time you are not sure what to do next,please contactPLEASE USE A PEN (NOT A PENCIL) WHEN FILLING OUT THE APPLICATION AND DO YOUR BEST TO PRINT CLEARLY.STEP 1: LIST ALL CHILDREN, INFANTS, AND STUDENTS UP TO AND INCLUDING GRADE 12Tell us how many infants/toddlers, children not in school, and elementary/middle/high school students live in your household. They do NOT have to be related to you to be a part of your household.Who should I list here? When filling out this section, please include ALL members in your household who are:•Children age 18 or under AND are supported with the household's income.

STEP 2: DO ANY HOUSEHOLD MEMBERS CURRENTLY PARTICIPATE IN SNAP, TANF, OR FDPIR?LblIf anyone in your household (including you) currently participates in one or more of the assistance programs listed below, your children are eligible for free school meals:•The Supplemental Nutrition Assistance Program (SNAP)LblIf no one in your household participates in any of the abovelisted programs:•Check "No" in STEP 2 and go to Step 3.

STEP 3.•Temporary Assistance for Needy Families (TANF)LblIf anyone in your household participates in any of the above listed programs:•The Food Distribution Program on Indian Reservations (FDPIR)•Write a case number for SNAP, TANF, or FDPIR. You only need to provide one case number. If you participate in one ofthese programs and do not know your case number, contact: State number 1-855-373-4636•Go to step 4

STEP 4.•In your care under a formal foster arrangement through a court or state/local agency, or qualify as homeless, migrant, or runaway youth;•Students attending,regardless of age.A) List each child's name. Print each child'sname. Use one line of the application for eachchild. When printing names, write one letter ineach box. Stop if you run out of space. If thereare more children present than lines on theapplication, attach a second piece of paper (ora second application if completingelectronically) with all required information forthe additional children. This also applies toadults in Step 3. "MI" is short for middle initial.Print the first letter of each child's middlename in the box.B) Building name/Grade. If child isa student, list building name andgrade.C) Do you have any foster children? If any childrenlisted are foster children, mark the "Foster Child"box next to the child's name. If you are ONLYapplying for foster children, after finishing STEP 1,go to STEP 4. Foster children who live with you maycount as members of your household and should belisted on your application. If you are applying forboth foster and non-foster children, go to step 3.Note: Adopted children are not considered fosterchildren. A foster child is a minor child who hasbeen taken into state custody and placed with astate-licensed adult, who cares for the child in placeof their parent or guardian.D) Are any children homeless, migrant, or runaway?If you believe any child listed in this section meetsthis description, mark the "Homeless, Migrant,Runaway" box next to the child's name and completeall steps of the application. Homeless, Migrant,Runaway status must be confirmed with theappropriate program staff. If the school districtcannot confirm your student's homeless, migrant, orrunaway status, then the school district will contactyou to complete and income-based application. Youmay choose to provide income information now inorder to prevent the school district from potentiallyneeding to contact you later.STEP 3: LIST ALL HOUSEHOLD MEMBERS AND INCOME FOR EACH MEMBERHow do I report my income?•Use the lists titled "Sources of Income for Adults" & "Sources of Income for Children," printed on the back side of the application form to determine if your household reporthas income to•Report all amounts in GROSS INCOME ONLY. Report all income in whole dollars. Do not include cents.◦Gross income is the total income received before taxes and deductions.◦Many people think of income as the amount they "take home" and not the total, "gross" amount. Make sure that the income you report on this application has NOT beenreduced to pay for taxes, insurance premiums, or any other amounts taken from your pay.Write a "0" in any fields where there is no income to report. Any income fields left empty or blank will also be counted as a zero. If you write '0' or leave any fields blank, you are certifying(promising) that there is no income to report. If local officials suspect that your household income was reported incorrectly, your application will be investigated.Mark how often each type of income is received using the check boxes to the right of each field.

3.A. REPORT INCOME EARNED BY ADULTSWho should I list here? •When filling out this section, please include ALL adult members in your household who are living with you and share income and expenses, even if they are not related and even if they do not receive income of their own.•Do NOT include:oPeople who live with you but are not supported by your household’s income AND do not contribute income to your household. oInfants, Children and students already listed in STEP 1. 1) List adult household members’ names. Print the name of each household member in the boxes marked “Names of Adult Household Members (First and Last).” Include collegestudents, unless they are declaredindependently on taxes (all college students areconsidered adults). Do not list any household members you listed in STEP 1.2) List earnings from work. List all total gross income from work in the“Earnings from Work” field on the application. total gross income from work in the “Earnings from Work” field on the application. This is usually the money received from working at jobs. If you are a self-employed business or farm owner, you will report your net income. What if I am self-employed? Report income from that work as a net amount. This is calculated by subtracting the total operating expenses of your business from its gross receipts or revenue. 3) List income from public assistance/child support/alimony. List allincome that applies in the “Public Assistance/Child Support/Alimony” field on the application. Do not report the cash value of any public assistance benefits NOT listed on the chart. If income is received fromchild support or alimony, only report court-ordered payments.Informal but regular payments should be reported as “other” income in the next part. 4) List income from pensions/retirement/allother income. List all income that applies in the “Pensions/Retirement/ All Other Income” fieldon the application. 5) List total household size. Enter the total number of household members in the field “Total Household Members (Children and Adults).” This number MUST be equal to the number of household members listed in STEP 1 and STEP 3. If there are any members of your household thatyou have not listed on the application, go back and add them. It is very important to list all household members, as the size of your household affects your eligibility for free and reduced price meals.6) Provide the last four digits of your Social Security Number. An adult household member must enter the last four digits of their Social Security Number in the space provided. You are eligible to apply for benefits even if you do not have a Social Security Number. If no adult household members have a Social Security Number, leave this spaceblank and mark the box to the right labeled “Check if no Social Security Number.”3.B. LIST INCOME EARNED BY CHILDRENList all income earned or received by children. List the combined gross income for ALL children listed in STEP 1 in your household in the box marked “Child Income.” Only count foster children’s income if you are applying for them together with the rest of your household. •What is Child Income? Child income is money received from outside your household that is paid DIRECTLY to your children. Many households do not have any child income. STEP 4: CONTACT INFORMATION AND ADULT SIGNATURE All applications must be signed by an adult member of the household. By signing the application, that household member is promising that all information has been truthfully and completely reported. Before completing this section, please also make sure you have read the statements on the back of the application. Provide your contact information. Write your current mailing address in the fields provided if this information is available. If you have no permanent address, that is okay. Sharing a phone number, email address, or both is optional, but helps us reach you quickly if we need to contact you. Print and sign your name and write today’s date. Print the name of the adult signing the application and that person signs in the box “Signature of adult.” Mail Completed Application to: OPTIONAL Share children’s racial and ethnic identities (optional). On the back of the application, we ask you to share information about your children’s race and ethnicity. This field is optional and does not affect your children’s eligibility for free or reduced price school meals. This information is requested solely for the purpose of determining the State’s compliance with Federal civil rights laws, and your response will not affect consideration of your application, and may be protected by the Privacy Act. By providing this information, you will assist us in assuring that this program is administered in a nondiscriminatory manner. Please return the application directly to your child’s SCHOOL. DO NOT mail, fax, or email completed applications or questions about applications to the USDA Office of the Assistant Secretary for Civil Rights or your child’s eligibility for free or reduced-price meals will be delayed. This institution is an equal opportunity provider.

 

Letter to Parents

FREQUENTLY ASKED QUESTIONS ABOUT FREE AND REDUCED PRICE SCHOOL MEALS

 

Dear Parent/Guardian:

 

Children need healthy meals to learn. [Name of School/School District] offers healthy meals every school day. Breakfast costs [$]; lunch costs [$]. Your children may qualify for free meals or for reduced price meals. Reduced price is [$] for breakfast and [$] for lunch. This packet includes an application for free or reduced price meal benefits, and a set of detailed instructions. Below are some common questions and answers to help you with the application process.

 

1.  Who can get free OR REDUCED PRICE meals?

• All children in households receiving benefits from the Food Stamp Program/Supplemental Nutrition Assistance Program (SNAP), the Food Distribution Program on Indian Reservations (FDPIR) or Temporary Assistance/Temporary Assistance for Needy Families (TANF), are eligible for free meals.
• Foster children that are under the legal responsibility of a foster care agency or court are eligible for free meals.
• Children participating in their school’s Head Start program are eligible for free meals.
• Children who meet the definition of homeless, runaway, or migrant are eligible for free meals.
• Children may receive free or reduced price meals if your household’s income is within the limits on the Federal Income Eligibility Guidelines. Your children may qualify for free or reduced price meals if your household income falls at or below the limits on this chart.

Household Size	Annually	Monthly	Weekly
1	$20,748	$1,729	$399
2	28,132	2,345	541
3	35,516	2,960	683
4	42,900	3,575	825
5	50,284	4,191	967
6	57,668	4,806	1,109
7	65,052	5,421	1,781
8	72,436	6,037	1,983
For each add’l person add	+7,384	+616	+142

 

 

 

 

 

 

 

 

 

 

 

 

 

2.  HOW DO I KNOW IF MY CHILDREN QUALIFY AS homeless, MIGRANT, OR RUNAWAY? Do the members of your household lack a permanent address? Are you staying together in a shelter, hotel, or other temporary housing arrangement? Does your family relocate on a seasonal basis? Are any children living with you who have chosen to leave their prior family or household? If you believe children in your household meet these descriptions and haven’t been told your children will get free meals, please call or e-mail [school, homeless liaison or migrant coordinator].

3.  Do I need to fill out an application for each child?  No. Use one Free and Reduced Price School Meals Application for all students in your household. We cannot approve an application that is not complete, so be sure to fill out all required information. Return the completed application to: [name, address, phone number].

4.  SHOULD I FILL OUT AN APPLICATION IF I RECEIVED A LETTER THIS SCHOOL YEAR SAYING MY CHILDREN ARE ALREADY APPROVED FOR FREE MEALS?  No, but please read the letter you got carefully and follow the instructions. If any children in your household were missing from your eligibility notification, contact [name, address, phone number, e-mail] immediately.

5.  MY CHILD’S APPLICATION WAS APPROVED LAST YEAR.  DO I NEED TO FILL OUT A NEW ONE?  Yes.  Your child’s application is only good for that school year and for the first few days of this school year.  You must send in a new application unless the school told you that your child is eligible for the new school year. 

6.  I GET WIC.  CAN MY CHILDREN GET FREE MEALS?  Children in households participating in WIC may be eligible for free or reduced price meals.  Please send in an application.

7.  Will the information I give be checked? Yes. We may also ask you to send written proof of the household income you report.

8.  If I don’t qualify now, may I apply later? Yes, you may apply at any time during the school year.  For example, children with a parent or guardian who becomes unemployed may become eligible for free and reduced price meals if the household income drops below the income limit.

 

 

9.  What if I disagree with the school’s decision about my application? You should talk to school officials. You also may ask for a hearing by calling or writing to: [name, address, phone number, e-mail].

10.  May I apply if someone in my household is not a U.S. citizen? Yes. You, your children, or other household members do not have to be U.S. citizens to apply for free or reduced price meals. 

11.  What if my income is not always the same? List the amount that you normally receive. For example, if you normally make $1000 each month, but you missed some work last month and only made $900, put down that you made $1000 per month.  If you normally get overtime, include it, but do not include it if you only work overtime sometimes.  If you have lost a job or had your hours or wages reduced, use your current income.

12.  WHAT IF SOME HOUSEHOLD MEMBERS HAVE NO INCOME TO REPORT? Household members may not receive some types of income we ask you to report on the application, or may not receive income at all. Whenever this happens, please write a 0 in the field. However, if any income fields are left empty or blank, those will also be counted as zeroes. Please be careful when leaving income fields blank, as we will assume you meant to do so.

13.  We are in the military. do we REPORT OUR INCOME DIFFERENTLY? Your basic pay and cash bonuses must be reported as income. If you get any cash value allowances for off-base housing, food, or clothing, or receive Family Subsistence Supplemental Allowance payments, it must also be included as income. However, if your housing is part of the Military Housing Privatization Initiative, do not include your housing allowance as income. Any additional combat pay resulting from deployment is also excluded from income.

14.  WHAT IF THERE ISN’T ENOUGH SPACE ON THE APPLICATION FOR MY FAMILY?  List any additional household members on a separate piece of paper, and attach it to your application. Contact [name, address, phone number, e-mail] to receive a second application.

15.  My family needs more help. Are there other programs we might apply for? To find out how to apply for the Food Stamp Program/SNAP or other assistance benefits, contact your local assistance office or call 1-855-373-4636.

16. {OPTIONAL STATEMENT} CAN I APPLY ONLINE? Yes! You are encouraged to complete an online application instead of a paper application if you are able. The online application has the same requirements and will ask you for the same information as the paper application. Visit [website] to begin or to learn more about the online application process. Contact [name, address, phone number, e-mail] if you have any questions about the online application.

If you have other questions or need help, call [phone number].

Sincerely,

 

 [signature]

 

USDA Non-discrimination Statement:

In accordance with federal civil rights law and USDA civil rights regulations and policies, the USDA, its agencies, offices, employees, and institutions participating in or administering USDA programs are prohibited from discriminating based on race, color, national origin, religion, sex, disability, age, marital status, family/parental status, income derived from a public assistance program, political beliefs, or reprisal or retaliation for prior civil rights activity, in any program or activity conducted or funded by USDA (not all bases apply to all programs). Remedies and complaint filing deadlines vary by program or incident.

Persons with disabilities who require alternative means of communication for program information (e.g., Braille, large print, audiotape, American Sign Language, etc.) should contact the state or local agency that administers the program or contact USDA through the Telecommunications Relay Service at 711 (voice and TTY). Additionally, program information may be made available in languages other than English.

To file a program discrimination complaint, complete the USDA Program Discrimination Complaint Form, AD-3027, found online at How to File a Program Discrimination Complaint and at any USDA office or write a letter addressed to USDA and provide in the letter all of the information requested in the form. To request a copy of the complaint form, call (866) 632-9992. Submit your completed form or letter to USDA by:

1. Mail: U.S. Department of Agriculture, Office of the Assistant Secretary for Civil Rights, 1400 Independence Avenue, SW, Mail Stop 9410, Washington, D.C. 20250-9410;
2. Fax: (202) 690-7442; or
3. Email: program.intake@usda.gov.

 

This institution is an equal opportunity provider.