Free and reduced price meal handbook

              CONTENTS
Page
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Administrative guidance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Prototype policy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Sample policy attachments :
Sample letters and applications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Sample public release . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 6
Sample collection procedures ............................. ~ . . . . . . . . 4 7
Policy checklist . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
Addendum . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
Parent letter in Spanish . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54
Application in Spanish . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55
Application adapted to computer use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56
1
INTRODUCTION
To carry out the Congressional intent that milk and nutritious meals be available
to every school child regardless of the family's ability to pay, the U.S. Department of
Agriculture (USDA) has established regulations which must be observed in all
schools that participate in the National School Lunch, School Breakfast, or Special
Milk Programs or that receive commodities. These provisions are contained in the
Code of Federal Regulations, Title 7, Part 245, "Determining Eligibility for Free or
Reduced-Price Meals and Free Milk."
These regulations outline specific responsibilities for all levels of administration:
1. By May 15 of each year the Secretary of Agriculture announces minimum and
maximum family-size and income guidelines to be used in determining eligi­bility
for free and reduced-price meals and free milk.
2. By July 1 of each year the State Educational Agencies and Food and Nutrition
Service Regional Offices prescribe, within the Secretary's guidelines, family-size
and income standards for free and reduced-price meals and free milk in their
States. In addition, they must issue detailed instructions to the school food
authorities on developing free and reduced-price policies. Often these instruc­tions
are a prototype policy which school food authorities may use in entirety.
3. Before the opening of school, each local school food authority must develop a
free and reduced-price policy, including family-size and income eligibility cri­teria
which conform with State or Regional Office standards. This policy must
be used in all schools under its administration participat~ng in the programs.
Each year a policy must be developed (or the previous one amended) and sub­mitted
to the State Educational Agency or FNS Regional Office for approval.
No school food authority shall be reimbursed for any meals or milk served after
September 30 of any fiscal year, nor use USDA commodities after that date,
unless the school food authority's free and reduced-price policy has been ap­proved
by the State or FNS Regional Office.
This handbook has been prepared as an aid in developing and implementing free and
reduced-price policies. It contains samples of a policy, letters to parents, applications,
a public release, and collection procedures as well as a summary of USDA's adminis­trative
decisions affecting free and reduced-price policies. The addendum contains a
letter to parents and application in Spanish and an application form for use by school
food authorities using computers.
3
•
Administrative
Guidance
Since Public Law 91-248 was
enacted, a large number of
operational questions have
arisen. The salient issues and
·the resulting administrative
decisions are presented in this
section .
ADMINISTRATIVE GUIDANCE
Q. What do I do at the beginning of the school year before applications for free and
reduced-price meals or free milk have been approved?
A. Applications and letters should be sent to all parents of school children within the
first week of school. Action should be taken within 10 working days on all applica­tions
returned to the school.
During the opening week of school, before applications for the new school year
are received and approved, school officials should serve free and reduced-price
meals and free milk to children from families with approved applications on file
from the previous school year.
Q. What is "income?"
A. "Income" means income before deductions for income taxes, employee's social
security taxes, insurance premiums, bonds, etc.
It includes the following: (1) Monetary compensation for services, including
wages, salary, commission, or fees; (2) net income from non-farm self-employ­ment;
( 3) net income from farm self-employment; ( 4) social security; ( 5) divi­dends
or interest on savings or bonds, income from estates or trust, or net rental
income; (6) public assistance or welfare payments; (7) unemployment compensa­tions;
{8) government civilian employee or military retirement or pensions or
veterans' payments; (9) private pensions or annuities; (10) alimony or child
support payments; (11) regular contributions from persons not living in the
household; {12) net royalties; and (13) other cash income. Other cash income
would include cash amounts received or withdrawn from any source including
savings, investments, trust accounts, and other resources, which would be avail­able
to pay the price of a child's meal.
"Income" as used here does not include income used for the following special
hardship conditions which could not reasonably be anticipated or controlled by the
household: (1) unusually high medical expenses; (2) shelter costs in excess of
30 percent of income as defined herein; (3) special education expenses due to the
mental or physical condition of a child; and ( 4) disaster or casualty losses.
In applying guidelines, school food authorities may consider both the income of
the family during the past 12 months and the family's current rate of income to
determine which is the better indicator of the need for free and reduced-price
meals.
Q. How do I consider the income of self-employed farmers or businessmen?
A. Net income from nonfarm self-employment is net money income (gross receipts
6
minus expenses) from one's business, professional enterprise, or partnership.
Gross receipts include the value of all goods sold and services rendered. Expenses
include cost of goods purchased, rent, heat, light, power, depreciation charges,
wages, and salaries paid, business taxes (not personal income taxes), etc. The
value of saleable merchandise consumed by the proprietors of retail stores is not
included as part of net income.
Net income from farm self-employment is net money income (gross receipts
minus operating expenses) from the operation of a farm by a person on his own
account, as an owner, renter, or sharecropper. Gross receipts include the value
of all products sold, government crop loans, money received from the rental of
farm equipment to others, and incidental receipts from the sale of wood, sand,
gravel, etc. Operating expenses include cost of feed, fertilizer, seed, and other
farming supplies, cash wages paid to farmhands, depreciation charges, cash rent,
interest on farm mortgages, farm building repairs, farm taxes (but not State and
Federal income taxes), etc. The value of fuel, food, or other farm products used
for family living is not included as part of net income. In general, inventory
changes are not considered in determining net income; however, replies based on
income tax returns or other official records do reflect inventory changes.
In both cases the key ·words are "gross receipts minus expenses," representing
the amount of money available for living expenses. Hardship provisions would be
applied to the income available for living expenses-not to the gross receipts.
Q. What do I do if a family suffers a temporary financial hardship?
A. In cases of temporary hardships affecting the community such as civil disorders,
natural disasters, etc., the school may grant approval for free and reduced-price
meals and free milk to children from families whose income falls within the
family-size income eligibility criteria, after deductions are made for the four
hardship conditions cited in the policy. In these instances, school officials may
want to base eligibility on the family's current rate of income rather than on the
family's annual income. However, the application must be completed as usual.
When the temporary condition has been alleviated, families approved under this
provision would be informed that the conditional approval will terminate within
a specific time (e.g., 10 days), and that those wishing continued assistance may
apply for a continuance of eligibility by submitting a new application.
Q. What do I do if a family suffers temporary financial problems d.ue to a strike?
A. In these instances school officials may base eligibility on the family's current rate
of income rather than on annual income. The application must be completed as
usual and approval should be granted only for the duration of the strike. If a
family wishes continued assistance after the strike is over, it should submit a new
application.
7
.Q. How do I compute military benefits for purposes of determining eligibility?
A. All cash income or payments made to a family must be considered as income as
defined in the Secretary's Income Poverty Guidelines. However, the value of bene­fits
other than cash, such as military base housing, is not to be considered as
income.
Q. What do I do when a father is serving in the military overseas?
A. In determining eligibility, the serviceman overseas is not counted as a family
member but the money he sends to his family is included in the family income.
Q. Can I certify a child to be eligible for free or reduced-price meals or free milk
if the child's parents have not sent in an application but I know the family
is needy?
A. If, after sending applications and letters to parents, a school official has not re­ceived
an application for a child he knows is needy, he may use family-size and
income information from another source to certify the child as eligible. In such
a situation, the school official should complete and file an application for that
child, setting forth the basis for that eligibility determination. In such an event
the school official should notify the family that its children are eligible for free or
reduced-price meals or free milk.
This does not give the school official authority to make eligibility determinations
or certifications by categories or groups of children.
Q. What can I do if I have reason to believe that a family's application contains false
information?
A. First, school officials must determine the child's eligibility based on the informa­tion
submitted on the application and extend appropriate benefits to that child.
However, once the application is approved, current regulations allow school offi­cials
to request a conference to provide an opportunity for the parent and school
official to discuss the situation, present information, and obtain an explanation
of the data submitted in the application or the decisions rendered. The request
for a conference may not in any way prejudice or diminish the right to a fair
hearing. After the conference, the school officials may verify the information and
if they believe the information on the application is false, they have an obligation
to challenge the continued eligibility of the child for free or reduced-price meals
or free milk.
8
The challenge must be made under the fair hearing procedures set forth in the
policy. The child continues to receive free or reduced-price meals or free milk
pending the outcome of the challenge.
The parents of a child should request that school officials cease to provide their
child with free milk and/ or meals (or change free meals to reduced-price meals)
if family circumstances improve. School officials should confirm the parents' re­quest
in writing or note on the child's application the date and nature of the
action requested by the parent.
Q. What do I do about granting free or reduced-price meals and free milk to foster
children?
A. In cases where the welfare agency is legally responsible for the child and the
foster home is, in fact, an extension of the welfare agency, the foster child is con­sidered
a. one-member family. Welfare agency payments for the care of that foster
child are considered the income of that one-member family. Therefore, if the
foster child's annual income is not above the income guidelines prescribed by the
local school food authority for one-member family eligibility for free or reduced­price
meals or free milk, the foster child is entitled to those benefits:
In cases where the welfare agency has placed a child in a permanent home and/or
subsidizes the child's adoption, the child is considered a member of the household
in which he resides. The family size and total income of the family determine the
child's eligibility for free and reduced-price meals and free milk.
Q. Are there any restrictions on disciplining free and reduced-price meal or free milk
recipients?
A. Denying free or reduced-price meals to children certified as eligible for such meals
is prohibited as disciplinary action (FNS Instruction 791-1). Section 9 of the
National School Lunch Act states that" ... any child who is a member of a house­hold
which has an annual income not above the applicable family size income level
set forth in the income poverty guidelines shall be served meals free or at reduced
cost." Public Law 92-32 mandates the same requirement for serving free or
reduced-price breakfasts. Thus, any disciplinary action which results in the denial
of free or reduced-price meals to eligible children is clearly contrary to the law.
When considering disciplinary action against any child certified as eligible for a
free or reduced-price meal, make sure that such action does not conflict with the
mandate of the National School Lunch Act (as amended) and the Child Nutrition
Act of 1966 (as amended) with respect to providing all needy children with a
free or reduced-price meal.
Q. Are there any restrictions against free and reduced-price meal or free milk recipi­ents
working in the lunchroom?
A. The regulations state that recipients of free or reduced-price meals or free milk
shall not be required to work for those benefits. However, they are not prohibited
from voluntarily working in the lunchroom.
Some schools employ student helpers in the cafeteria for monetary or other com­pensation.
In these cases, parents of all workers should be informed in writing
that their children have volunteered to work. The letter should state that if the
child has been certified as eligible for a free or reduced-price meal or free milk,
his continued eligibility is in no way dependent upon his working. Additionally,
the letter should not be a part of nor attached to the free and reduced-price letter
to parents, application, or notice of approval/denial.
Q. Do I have to serve reduced-price meals?
A. Although the State Educational Agencies and FNS Regional Offices must pre­scribe
eligibility standards for reduced-price meals, the school food authority has
the option of offering those benefits. However, a school can extend benefits to a
larger number of needy children by serving reduced-price meals.
Q. What should I charge for a reduced-price meal?
A. The reduced price must be less than the full price of the lunch or breakfast and
may not exceed 20 cents for lunch or 10 cents for breakfast. In addition, although
the charge for a full-price meal may be more in the high school than in the grade
school, the charges for reduced-price meals in the high schools and grade schools
under one school food authority must be the same to ensure that all children from
the same family receive the same benefits.
Q. If I serve reduced-price lunches do I have to serve reduced-price breakfasts?
A. If your school participates in the National School Lunch Program and the School
Breakfast Program and you serve free and reduced-price lunches, you must also
serve free and reduced-price breakfasts.
Q. What do I do if I offer two lunches at different prices?
A. Frequently, in an effort to increase participation, schools offer students a choice
between two Type A lunches. Occasionally, one lunch is slightly more expensive
than the other. In these cases, free and reduced-price meal recipients must be able
to choose either meal at no charge or at the standard reduced price, whichever
the student regularly receives.
10
•
Prototype
Policy
Each local school food author­ity
must submit a free and
reduced-price policy to the
State Agency or FNS Regional
Office for approval prior to the
opening of school. This sec­tion
contains a sample of such
a policy .
SAMPLE POLICY STATEMENT FOR FREE AND REDUCED­PRICE
MEALS AND FREE MILK
The (name of school food authority) has agreed to participate in the (choose which­ever
are applicable: National School Lunch Program, School Breakfast Program,
Special Milk Program, and/ or to receive commodities donated by USDA) and accepts
responsibility for providing (choose whichever are applicable: free and reduced-price
meals, free milk) to eligible children in the schools under its .~utisdiction.
The school food authority assures the (choose whichever is applicable: State Depart­ment
of Education or Food and Nutrition Service Regional Office) that the school
system will uniformly implement the following policy to determine children's eligi­bility
for free and reduced-price meals in all National School Lunch Program, School
Breakfast Program, and commodity-only schools under its jurisdiction and to deter­mine
children's eligibility for free milk in all Special Milk Program schools under
its jurisdiction. In fulfilling its responsibilities the school food authority:
A. Agrees to serve meals free to children from families whose income is at or below
that listed in Attachment A.
B. Agrees to serve milk free to children from families whose income is at or below
that listed in Attachment A.
C. Agrees to serve meals at a reduced price to children from families whose income
is at or below that listed in Attachment B.1
1 NOTE: If the school food authority has determined that it will not serve
reduced-price meals, this reference and Attachment B should be de­leted.
D. Agrees to provide these benefits to any child whose family's income falls within
the criteria in Attachment A orB after deductions are made for special hardship
conditions which could not reasonal?ly be anticipated or controlled by the house­hold,
due to unusually high medical expenses, shelter costs in excess of 30 percent
of reported income, special education expenses due to the mental or physical con­dition
of a child, and disaster or casualty losses; in addition, agrees to provide
these benefits to foster children in certain cases.
E. Agrees that there will be no physical segregation of, nor any other discrimination
against, any child because of his inability to pay the full price of the meal or milk.
The names of the c(lildren eligible to receive free or reduced-price meals and free
milk shall not be pu1)1ished, posted, or announced in any manner and there shall
be no overt identification of any such children by use of special tokens or tickets
or any other means. Further assurance is given that children eligible for free or
reduced-price meals or free milk shall not be required to:
1. Work for their meals or milk.
2. Use a separate lunchroom.
3. Go through a separate serving line.
4. Enter the lunchroom through a separate entrance.
12
5. Eat meals or drink milk at a different time.
6. Eat a meal different from the one sold to children paying the full price or
drink milk different from that sold to children paying the full price.
F. Agrees that.irdhe operation of child feeding programs, no child shall be discrimi­nated
again~t because of race, sex, color, or national origin.
G. Agrees to establish and use a fair hearing procedure for parents' appeals of the
school's decisions on applications and for school officials' challenges to the correct­ness
of information contained in an application or to the continued eligibility
of any child for free or reduced-price meals or free milk. During the appeal and
hearing the child will continue to receive free or reduced-price meals or free milk.
A record of all such appeals and challenges and their dispositions shall be re­tained
for 3 years.
Prior to initiating the hearing procedure, the parent or local school official may
request a conference to provide an opportunity for the parent and school official
to discuss the situation, present information, and obtain an explanation of data
submitted in the application and decisions rendered. Such a conference shall not
in any way prejudice or diminish the right to a fair hearing.
The hearing procedure shall provide the following:
1. A publicly-announced, simple method for making an o~al or written request
for a hearing.
2. An opportunity to be assisted or represented by an attorney or other person.
3. An opportunity to examine, prior to and during the hearing, the documents
and records presented to support the decision under appeal.
4. Reasonable promptness and convenience in scheduling a hearing and ade­quate
notice as to the time and place of the hearing.
5. An opportunity to present oral or documentary evidence and arguments
supporting its position.
6. An opportunity to question or refute any testimony or other evidence and
to confront and cross-examine any adverse witnesses.
7. That the hearing be conducted and the decision made by a hearing official
who did not participate in the decision under appeal.
8. That the decision of the hearing official be based on the oral and documen­tary
evidence presented at the hearing and made a part of the hearing
record~
9. That the parties concerned and any designated representative thereof be
notified in writing of the decision of the hearing official.
10. That for each hearing a written record be prepared, including the decision
under appeal, any documentary evidence and a summary of any oral testi­mony
presented at the hearing, the decision of the hearing official and· the
reasons therefor, and a copy of the notification to the parties concerned of
the hearing official's decision.
11. That such written record be preserved for a period of 3 years and shall be
available for examination by the parties concerned or their representatives
at any reasonable time and place during such period.
13
H. Agrees to designate (name and title) to review applications and make determina­tions
of eligibility. This official will use the criteria outlined in this policy to deter­mine
which individual children are eligible for free or reduced-price meals and
free milk.
I. Agrees to develop and send to each child's parent or guardian a letter as outlined
herein, including an application form for free or reduced-price meals and free
milk at the beginning of each school year and whenever there is a change in
eligibility criteria.
Parents will be requested to complete the application and return it to the deter­mining
official (named in H) for review. Such applications and documentation
of action taken will be maintained for 3 years after the end of the fiscal year
to which they pertain.
Applications may be filed at any time during the year. Any parent enrolling a
child in a school for the first time, at any time during the year, shall be supplied
with such documents. If a child transfers from one school to another under the
jurisdiction of the same school food authority, his eligibility for a free or reduced­price
meal and free milk will be transferred to and honored by the receiving
school.
All children from a family will receive the same benefits. Within -ten working
days of the receipt of applications, parent& or guardians will be notified individ­ually
of the acceptance or denial of their applications. Children will be served
meals and milk immediately upon the establishment of their eligibility.
When an application is rejected parents or guardians will be informed of the
reason for denial and the hearing procedure. The designated hearing official is
(name, title, address) .2
2 NOTE: This person must be someone not involved in the original eligibility
determination. Further, it is suggested that he hold a position superior
to that of the determining official.
J. Agrees to submit to the informational media a public release containing the same
information outlined in the parent letter.
K. Agrees to establish a procedure to collect from children who pay for their meals
and milk and to account for the number of free, reduced-price, and full-price
meals served and the number of half-pints of free and full-price milk served. The
procedure described in Attachment F will be used so that no other child in the
school will consciously be made aware by such procedure of the identity of the
children receiving reduced-price meals or free milk and meals.3
L. Agrees to submit to the (choose whichever is applicable: State Department of
Education or Food and Nutrition Service Regional Office) any alterations, public
announcements, etc., prior to implementation. Such changes will be effective only
14
upon approval. All changes in eligibility criteria must be publicly announced in
the same manner used at the beginning of the school year.
s NOTE: Describe in detail in Attachment F the payment collection method (s)
used in each school or group of schools.
Attachments: The following attachments are adopted with and considered part
of this policy.
Attachment A-Eligibility criteria for free meals and free milk
Attachment B-Eligibility criteria for reduced-price meals
Attachment C-Letter to parents
Attachment D-Application form
Attachment E-Public release
Attachment F -Collection procedure
Approved by:
(Signature of local school official
(Signature of State Director or FNSRO
Representative)
(date)
(date)
15
ATTACHMENT A
FAMILY-SIZE AND INCOME SCALE FOR FREE MEALS
AND FREE MILK
This is the income scale used by (school food authority) to determine eligibility for
free meals and free milk in the (date) school year.
16
Family Size
1
2
3
4
5
6
7
8
9
10
11
12
Each additional
family member
Income
Insert eligibility scale for free
meals and free milk.
ATTACHMENT B
FAMILY-SIZE AND INCOME SCALE FOR REDUCED PRICE MEALS
This is the income scale used by (school food authority) to determine eligibility for
reduced-price mea~s in the (date) school year.
Family Size
1
2
3
4
5
6
7
8
9
10
11
12
Each additional
family member
Income
Insert eligibility scale for
reduced-price meals.
ATTACHMENT C
PARENT LETTER
School Name ___________________________________________________ ___
This is the parent letter exactly as we will send out on ___ (date) .;.....______; _ ___...
(The appropriate letter to parents, chosen from "policy attachments" section
should be inserted here.)
17
ATTACHMENT D
APPLICATION FORM
This is the application adopted by ------------- School (s) for the
(date) school year:
(The appropriate application chosen from "policy attachments" section
should be inserted here.)
ATTACHMENT E
PUBLIC RELEASE
School Food Authority:--------------------­This
is the public release that we will send to (names of news media outlets) on
(date)
(See the "policy attachments" section for a suggested format.)
ATTACHMENT F
COLLECTION PROCEDURE
------------------------ School(s)
use (s) the following collection procedure:
(If more than one system of collection is used, explain them all and indicate which
schools use which system.)
(Describe in detail, including the method used to distribute tokens, tickets, etc.; the
method used to collect children's payments-where, when, how; and the method used
to account for full-price, free, and reduced-price meals and free and full-price milk
each day. If tokens or tickets are used, attach a free, a reduced-price, and a full-price
ticket or token. See the "policy attachments" section for suggested procedures.)
18
LETTERS TO PARENTS AND APPLICATION FORMS
Following are thirteen letters and applications arranged by type of food service
offered and by whether or not reduced-price meals are served in addition to free and
full-price meals. Each school food authority should select the appropriate one for its
schools to use.
Letter and application For use in schools offering Page reference
A Breakfast, lunch, and milk with 20/21
reduced-price meals
B Breakfast, lunch, and milk 22/23
with no reduced price
c Breakfast and lunch with 24/25
reduced price meals
D Breakfast and lunch with no 26/27
reduced price
E Lunch and milk with reduced-price 28/29
meals
F Lunch and milk with no reduced price 30/31
G Breakfast and milk with 32/33
reduced-price meals
H Breakfast and milk with 34/35
no reduced price
I Lunch only with reduced-price 36/37
J Lunch only with no reduced price 38/39
K Breakfast only with 40/41
reduced-price meals
L Breakfast only with 42/43
no reduced price
M Milk only 44/45
19
Breakfast, lunch, and milk
with reduced-price meals
Dear Parent or Guardian:
LETTER A
. The ------ --- ---- ---- ---- School serves nutritious meals
every school day. Students may buy lunch for cents, breakfast for ----
cents, and extra milk for cents.
Children from families whose income is at or below the levels shown on the attached
scale are eligible for free milk and for meals free or at the reduced prices of __ _
cents for lunch and cents for breakfast. If your income is greater than those
shown but you have unusually high medical bills, shelter costs in excess ·of 30 percent
of your income, special education expenses due to the mental or physical condition of
a child, or disaster or casualty losses, your children may still be eligible.
To apply at any time during the year for free or reduced-price meals and free milk
for your children, complete the attached application and return it to the school.
Within days of receiving your application, the school will let you know
whether or not your children are eligible. If you do not agree with· the school's
decision you have a right to a fair hearing. This can be done by calling or writing
(name, address, phone)
In certain cases foster children are also eligible for these benefits. If you have foster
children living with you and wish to apply for such meals and milk for them, please
notify us or indicate it on the application.
All children are treated the same regardless of ability to pay. In the operation of
child feeding programs, no child will be discriminated against because of race, sex,
color, or national origin.
If we can be of any further assistance or if your income changes during the year,
please contact us.
Sincerely,
(name)
(title)
20
Breakfast, lunch, and milk
with reduced-price meals
APPLICATION
APPLICATION A
Date _________ _
Parents: To apply for free or reduced-price meals and free milk for your children,
fill out this form and return it to the school office.
Names and grades of children for whom application is made: -----------------
Name and address of parent or guardian:---------------------------------
Total number in family: _________ __
Total family income before deductions. Include wages of all working members, wel­fare
payments, pensions, social security, and all other income. Fill in one: Yearly
____ Monthly Weekly __ _
If your gross family income exceeds the amount indicated in the attached family
income scale and you wish to apply under any of the special hardship conditions
cited in the attached letter, please complete the application form and also describe
the nature of your hardship here: ---------------------------------------
In certain cases foster children are eligible for free or reduced-price meals and free
milk regardless of your family income. If you have foster children living with you
and wish to apply for such meals and milk for them, please check here: ______ _
I hereby certify that all of the above irifortnation is true and correct to the best of
my knowledge and belief.
Signature of adult family member
FORSCHOOLUSEONLY
Date, _____________ _
Your application for free and reduced-price meals and free milk for your children
has been:
_______ Approved for free meals and free milk.
________ Approved for reduced-price meals at _______ cents for lunch
and cents for breakfast.
________ Denied for the following reasen
You may appeal this decision by calling or writing (name and title) at (address and
phone number).
21
Breakfast, lunch, and milk
with no reduced-price meals
Dear Parent or Guardian:
LE'ITER B
The School · serves nutritious
meals and milk every school day. Students may buy lunch for cents, break-fast
for cents, and milk for cents.
Children from families whose income is at or below the levels shown on the attached
scale are eligible for free meals and milk. If your income is greater than those
shown but you have unusually high medical bills, shelter costs in excess of 30 per­cent
of your income, special education expenses due to the mental or physical con­dition
of a child, or disaster or casualty losses, your children may still be eligible.
To apply at any time during the year for free meals and milk for your children,
complete the attached application and return it to the school. Within days
of receiving your application, the school will let you know whether or not your
children are eligible. If you do not agree with the school's decision you have a right
to a fair hearing. This can be done by calling or writing (name, address, phone)
In certain cases foster children are also eligible for these benefits. If you have foster
children living with you and wish to apply for such meals and milk for them,
please notify us or indicate it on the application.
All children are treated the same regardless of ability to pay~ In the operation of
child feeding programs, no child will be discriminated against because of race, sex,
color, or national origin.
If we can be of any further assistance or if your income changes during the year,
please contact us.
Sincerely,
(name)
(title)
22
Breakfast, lunch, and milk
with no reduced-price meals
APPLICATION
APPLICATION B
Date ____ _
Parents : To apply for free meals and milk for your children, fill out this form and
return it to the school office.
Names and grades of children for whom application is made: ________ _
Name and address of parent or guardian: ________________ _
Total number in family: _______ _
Total family income before deductions. Include wages of all working members, wel­fare
payments, pensions, social security, and all other income. Fill in one: Yearly
____ Monthly Weekly ___ _
If your gross family income exceeds the amount indicated in the attached family
income scale and you wish to apply under any of the special hardship conditions
cited in the attached letter, please complete the application form and also describe
the nature of your hardship here: --------------------
In certain cases foster children are eligible for free meals and milk regardless of
your family income. If you have foster children living with you and wish to apply
for such meals and milk for them, please check here: ___ _
I hereby certify that all of the above information is true and correct to the best
of my knowledge and belief.
Signature of adult family member
FOR SCHOOL USE ONLY
Date ____ _
Your application for free meals and milk for your children has been:
____ Approved for free meals and free milk.
____ Denied for the following reason:
You may appeal this decision by calling or writing (name and title) at (address
and phone number).
23
Breakfast and lunch with
reduced-price meals
Dear Parent or Guardian:
LETTER C
The ______________ School serves nutritious meals every school
day. Students may buy lunch for cents and breakfast for cents.
Children from families whose income is at or below the levels shown on the attached
scale are eligible for meals free or at the reduced prices of cents for lunch
and cents for breakfast. If your income is greater than those shown but
you have unusually high medical bills, shelter costs in excess of 30 percent of your
income, special education expenses due to the mental or physical condition of a
child, or disaster or casualty losses, your children may still be eligible.
To apply at any time during the year for free or reduced-price meals for your
children, complete the attached application and return it to the school. Within
____ days of receiving your application, the school will let you know whether
or not your children are eligible. If you do not agree with the school's decision you
have a right to a fair hearing. This can be done by calling or writing (name,
address, phone).
In certain cases foster children are also eligible for these benefits. If you have foster
children living with you and wish to apply for such meals and milk for them,
please notify us or indicate it on the application.
All children are treated the same regardless of ability to pay. In the operation of
child feeding programs, no child will be discriminated against because of race, sex,
color, or national origin.
If we can be of any further assistance or if your income changes during the year,
please contact us.
Sincerely,
(name)
(title)
24
APPLICATION APPLICATION C
Breakfast, and lunch with
reduced-price meals
Date ____ _
Parents: To apply for free or reduced-price meals for your children, fill out this
form and return it to the school office.
Names and grades of children for whom application is made:
Name and address of parent or guardian: ________________ _
Total number in family: ___ _
Total family income before deductions. Include wages of all working members, wel­fare
payments, pensions, social security, and all other income. Fill in one: Yearly
____ Monthly Weekly ___ _
If your gross family income exceeds the amount indicated in the attached family
income scale and you wish to apply under any of the special hardship conditions
cited in the attached letter, please complete the application form and also describe
the nature of your hardship here: ___________________ _
In certain cases foster children are eligible for free meals and milk regardless of
your family income. If you have foster children living with you and wish to apply
for such meals and milk for them, please check here: ___ _
I hereby certify that all of the above information is true and correct to the best
of my knowledge and belief.
Signature of adult family member
FOR SCHOOL USE ONLY
Date, ____ _
Your application for free and reduced-price meals for your children has been:
____ Approved for free meals.
____ Approved for reduced-price meals at cents for
lunch and cents for breakfast.
____ Denied for the following reason:
You may appeal this decision by calling or writing (name and title) at (address
and phone number).
25
Breakfast and lunch with
no reduced-price meals
Dear Parent or Guardian:
LETTER D
The ______________ School serves nutritious meals every school
day. Students may buy lunch for ___ cents and breakfast for cents.
Children from families whose income is at or below the levels shown on the attached
scal.e are eligible for free meals. If your income is greater than those shown but you
have unusually high medical bills, shelter costs in excess of 30 percent of your
income, special education expenses due to the mental or physical condition of a
child, or disaster or casualty losses, your children may still be eligible.
To apply at any time during the year for free meals for your children, complete
the attached application and return it to the school. Within days of receiv­ing
your application, the school will let you know whether or not your children are
eligible. If you do not agree with the school's decision you have a right to a fair
hearing. This can be done by calling or writing (name, address, phone)
In certain cases foster children are also eligible for these benefits. If you have
foster children living with you and wish to apply for such meals for them, please
notify us or indicate it on the application.
All children are treated the same regardless of ability to pay. In the operation of
child feeding programs, no child will be discriminated against because of race, sex,
color, or national origin.
If we can be of any further assistance or if your income changes during the year,
please contact us.
Sincerely,
(name)
(title)
26
Breakfast and lunch with no
reduced-price meals
APPLICATION
APPLICATION D
Date _____ _
Parents: To apply f1;:- free meals for your children, fill out this form and return it to
the school office.
Names and grades of children for whom application is made: ---------.---
Name and address of parent or guardian: ________________ _
Total number in family: _____ _
Total family income before deductions. Include wages of all working members, wel­fare
payments, pensions, social security, and all other income. Fill in one:
Yearly Monthly Weekly __ _
If your gross family income exceeds the amount indicated in the attached family in­come
scale and you wish to apply under any of the special hardship conditions cited
in the attached letter, please complete the application form and also describe the
nature of your hardship here: -----------------------
In certain cases foster children are eligible for free meals and milk regardless of your
family income. If you have foster children living with you and wish to apply for
such meals and milk for them, please check here: ___ _
I hereby certify that all of the above information is true and correct to the best of
my knowledge and belief.
Signature of adult family member
FOR SCHOOL USE ONLY
Date _____ _
Your application for free meals for your children has been:
____ Approved for free meals.
____ Denied for the following reason :
You may appeal this decision by calling or writing (name and title) at
(address and phone number)
27
·Lunch and milk with
reduced-price meals
Dear Parent or Guardian:
LETTER E
The School serves nutritir..:Is lunches and milk
every school day. Students may buy lunch for cents aild extra milk for
___ .cents.
Children from families whose income is at or below the levels shown on the attached
scale are eligible for free milk and for lunches free or at the reduced price of __
cents. If your income is greater than those shown but you have unusually high medi­cal
bills, shelter costs in excess of 30 percent of your income, special education ex­penses
due to the mental or physical condition of a child, or disaster or casualty
losses, your children may still be eligible.
To apply at any time during the year for free or reduced-price lunches and free milk
for your children, complete the attached application and return it to the school.
Within days of receiving your application, the school will let you know
whether or not your children are eligible. If you do not agree with the school's de­cision
you have a right to a fair hearing. This can be done by calling or writing
(name; -address, phone)
In certain cases foster children are also eligible for these benefits. If you have foster
children living with you and wish to apply for such lunches and milk for them, please
notify us or indicate it on the application.
All children are treated the same regardless of ability to pay. In the operation of
child feeding programs, no child will be discriminated against because of race, sex,
color, or national origin.
If we can be of any further assistance or if your income changes during the year,
please contact us.
Sincerely,
(name)
(title)
28
l
1
Lunch and milk with
reduced-price meals
APPLICATION
APPLICATION E
Date _____ _
Parents : To apply for free or reduced-price lunches and free milk for your children,
fill out this form and return it to the school office.
Names and grades of children for whom application is made: _______ .......__
Name and address of parent or guardian: -----------------
Total number in family: _____ _
Total family income before deductions. Include wages of all working members, wel­fare
payments, pensions, social security, and all other income. Fill in one:
Year Monthly Weekly __ _
If your gross family income exceeds the amount indicated in the attached family in­come
scale and you wish to apply under any of the special hardship conditions cited
in the attached letter, please complete the application form and also describe the
nature of your hardship here: ----,----------------------
In certain cases foster children are eligible .for . free or reduced-price lunches and
free milk regardless of your family income. If you have foster children living with
you and wish to apply for such lunches or milk for them, please check here: __ _
I hereby certify that all of the above information is true and correct to the best of
my knowledge and belief.
Signature of adult family member
FOR SCHOOL USE ONLY
Date _____ _
Your application for ,free or reduced-price lunches and free milk for your children
has been:
___ _..Approved for free lunches and free milk.
___ _ Approved for reduced-price lunches at ___ cents each.
____ Denied for the following reason:
You may appeal this decision by calling or writing (name and title)
at (address and phone number) ---~-----~---
29
LETTER F
Lunch and milk with
no reduced-price meals
Dear Parent or Guardian:
The School serves nutritious lunches and milk
every school day. Students may buy lunch for cents and milk for __ _
cents.
Children from families whose income is at or below the levels shown on the attached
scale are eligible for free lunches and milk. If your income is greater than those
shown but you have unusually high medical bills, shelter costs in excess of 30 per­cent
of your income, special education expenses due to the mental or physical condi­tion
of a child, or disaster or casualty losses, your children may still be eligible.
To apply at any time during the year for free lunches and milk for your children,
complete the attached application and return it to the school. Within days of
receiving your application, the school will let you know whether or not your children
are eligible. If you do not agree with the school's decision you have a right to a fair
hearing. This can be done by calling or writing (name, address, phone)
In certain cases foster children are also eligible for these benefits. If you have foster
children living with you and wish to apply for such lunches and milk for them, please
notify us or indicate it on the application.
All children are treated the same regardless of ability to pay. In the operation of
child feeding programs, no child will be discriminated against because of race, sex,
color, or national origin.
If we can be of any further assistance or if your income changes during the year,
please contact us.
Sincerely,
(name)
(title)
30
APPLICATION F
Lunch and milk with no
reduced-price meals
APPLICATION
Date, ____ _
Parents: To apply for free lunches and milk for your children, fill out this form and
return it to the school office.
Names and grades of children for whom application is made:---------
Name and address of parent or guardian:
Total number in family:
Total family income before deductions. Include wages of all working members, wel­fare
payments, pensions, social security, and all other income. Fill in one:
Yearly Monthly Weekly __ _
If your gross family income exceeds the amount indicated in the attached family
income scale and you wish to apply under any of the special hardship conditions
cited in the attached letter, please complete the application form and also describe
the nature of your hardship here: --------------------
In certain cases foster children are eligible for free meals and milk regardless of
your family income. If you have foster children living with you and wish to apply for
such meals and milk for them, please check here: _____ _
I hereby certify that all of the above information is true and corrtlct to the best of
my knowledge and belief.
Signature of adult family member
FOR SCHOOL USE ONLY
Your application for free lunches and milk for your children has been:
____ Approved for free lunches and free milk.
____ Denied for the following reason :
You may appeal this decision by calling or writing (name and title)
at (address and phone number) ___ ;..__ ____ ...;.;......:...:.. _ _
31
LETTER G
Breakfast and milk
with reduced-price meals
Dear Parent or Guardian:
The School serves nutritious breakfasts and
milk every school day. Students may buy breakfast for cents and extra milk
for cents.
Children from families whose income is at or below the levels shown on the attached
scale are eligible for free milk and for breakfasts free or at the reduced price of
___ cents. If your income is greater than those shown but you have unusually
high medical bills, shelter costs in excess of 30 percent of your income, special edu­cation
expenses due to the mental or physical condition of a child, or disaster or
casualty losses, your children may still be eligible.
To apply at any time during the year, for free or reduced-price breakfasts and free
milk for your children, complete the attached application and return it to the school.
Within days of receiving your application, the school will let you know
whether or not your children are eligible. If you do not agree with the school's
'decision you have a right to a fair hearing. This can be done by calling or writing
(name, address, phone)
In certain cases foster children are also eligible for these benefits. If you have foster
children living with you and wish to apply for such breakfasts and milk for them,
please notify us or indicate it on the application.
All children are treated the same regardless of ability to pay. In the operation of
child feeding programs, no child will be discriminated against because of race, sex,
color, or national origin.
If we can be of any further assistance or if your income changes during the year,
please contact us.
Sincerely,
(name)
(title)
32
Breakfast and milk with
reduced-price meals
APPLICATION G
APPLICATION
Date _____ _
Parents: To apply for free or reduced-price breakfasts and free milk for your chil­dren,
fill out this form and return it to the school office.
Names and grades of children for whom application is made: _______ _
Name and address of parent or guardian: ________________ _
Total number in family: ___ _
Total family income before deductions. Include wages of all working members, wel­fare
payments, pensions, social security, and all other income. Fill in one:
Yearly ___ Monthly Weekly __ _
If your gross family income exceeds the amount indicated in the attached family
income scale and you wish to apply under any of the special hardship conditions
cited in the attached letter, please complete the application form and also describe
the nature of your hardship here: --------------------
In certain cases foster children are eligible for free or reduced-price breakfasts
and free milk regardless of your family income. If you have foster children living
with you and wish to apply for such breakfasts and milk for them, please check
here ___ _
I hereby certify that all of the above information is true and correct to the best of
my knowledge and belief.
Signature of adult family member
FOR SCHOOL USE ONLY
Your application for free or reduced-price breakfasts and free milk for your chil­dren
has been :
___ Approved for free breakfasts and free milk.
_____ Approved for reduced-price breakfasts at ___ cents.
____ Denied for the following reason:
You may appeal this decision by calling or writing (name and title)
at (address and phone number) ----'--------'----
33
Breakfast and milk with
no reduced-price meals
Dear Parent or Guardian:
LETTER H
The School serves nutritious breakfasts and
milk every day. Students may buy breakfast for ___ cents and extra milk for
____ cents.
Children from families whose income is at or below the levels shown on the attached
scale are eligible for free breakfasts and milk. If your income is greater than those
shown but you have unusually high medical bills, shelter costs in excess of 30 per-
. cent of your income, special education expenses due to the mental or physical con­dition
of a child, or disaster or casualty losses, your children may still be eligible.
To apply at any time during the year for free breakfasts and milk for your chil-dren,
complete the attached application and return it to the school. Within __ _
days of receiving your application, the school will let you know whether or not your
children are eligible. If you do not agree with the school's decision you have a right
to a fair hearing. This can be done by calling or writing (name, address, phone)
In certain cases foster children are also eligible for these benefits. If you have foster
children living with you and wish to apply for such breakfasts and milk for them,
please notify us or indicate it on the application.
All children are treated the same regardless of ability to pay. In the operation of
child feeding programs, no child will be discriminated against because of race, sex,
color, or national origin.
If we can be of any further assistance or if your income changes during the year,
please contact us.
_e.,
Sincerely. )
(name)
(title)
34
Breakfast and milk with
no reduced-price meals
APPLICATION
APPLICATION H
Date _____ _
Parents: To apply for free breakfasts and milk for your children, :fill out this form
and return it to the school office.
Names and grades of children for whom application is made:----·-----
N arne and address of parent or guardian: ________________ _
Total number in family: ___ _
Total family income before deductions. Include wages of all working members, wel­fare
payments, pensions, social security, and all other income. Fill in one:
Yearly Monthly Weekly __ _
If your gross family income exceeds the amount indicated in the attached family in­come
scale and you wish to apply under any of the special hardship conditions cited
in the attached letter, please complete the application form and also describe the na­ture
of your hardship here: ----------------------
In certain cases foster children are eligible for free meals and milk regardless of
your family income. If you have foster children living with you and wish to apply
for such meals and milk for them, please check here: ___ _
I hereby certify that all of the above information is true and correct to the best of
my knowledge and belief.
Signature of adult family member
FOR SCHOOL USE ONLY
Your application for free breakfasts and free breakfasts and free milk for your chil­dren
has been :
____ Approved for free breakasfs and free milk.
____ Denied for the following reason:
You may appeal this decision by calling Qr writing (name and title)
at (address and phone number) ___ ....;...._....;_.......;..:..:....;.......;.~---
35
LETTER I
Lunch only, with reduced-price meals
Dear Parent or Guardian:
The School serves nutritious lunches every
school day. Students may buy lunch for ___ cents.
Children from families whose income is at or below the levels shown on the attached
scale are eligible for lunches free or at the reduced price of cents. If your
income is greater than those shown but you have unusually high medical bills, shel­ter
costs in excess of 30 percent of your income, special education expenses due to the
mental or physical condition of a child, or disaster or casualty losses, your children
may still be eligible.
To apply at any time during the year for free or reduced-price lunches for your
children, complete the attached application and return it to the school. Within __ _
days of receiving your application, the school will let you know whether or not your
children are eligible. If you do not agree with school's decision you have a right to
a fair hearing. This can be done by calling or writing (name, address, phone)
In certain cases foster children are also eligible for these benefits. If you have · foster
children living with you and wish to apply for such· lunches for them, please notify
us or indicate it on the application.
All children are treated the same regardless of ability to pay. In the operation of
child feeding programs, no child will be discriminated against because of race, sex,
color, or national origin.
If we can be of any further assistance or if your income changes during the year,
please contact us.
Sincerely,
(name)
(title)
36
APPLICATION I
Lunch only, with reduced-price meals
APPLICATION
Date _____ _
Parents: To apply for free or reduced-price lunches for your children, fill out this
form and return it to the school office.
Names and grades of children for whom application is made:---------
Name and address of parent or guardian:
Total number in family: ___ _
Total family income before deductions. Include wages of all working members, wel­fare
payments, pensions, social security, and all other income. Fill in one:
Yearly Monthly Weekly __ _
If your gross family income exceeds the amount indicated in the attached family in­come
scale and you wish to apply under any of the special hardship conditions cited
in the attached letter, please complete the application form and also describe the
nature of your hardship here: ----------------------
In certain cases foster children are eligible for free or reduced-price lunches re­gardless
of your family income. If you have f9ster children living with you and wish
to apply for such lunches for them, please check · here: __ _
I hereby certify that all of the above information is true and correct to the best of
my knowledge and belief.
Signature of adult family member
FOR SCHOOL USE ONLY
Your application for free or reduced-price lunches for your children has been:
___ __.Approved for free lunches.
____ Approved for reduced-price lunches at cents.
____ Denied for the following reason:
You may appeal this decision by calling or writing (name and title)
at (address and phone number) -----'-------'---
37
Lunch only, with no
reduced-price meals
Dear Parent or Guardian:
LETTER J
The School serves nutritious lunches every
school day. Students may buy lunch for cents.
Children from families whose income is at or below the levels shown on the attached
scale are eligible for free lunches. If your income is greater than those shown but
you have unusually high medical bills, shelter costs in excess of 30 percent of your
income, special education expenses due to the mental or physical condition of a
child, or disaster or casualty losses, your children may still be eligible.
To apply at any time during the year for free lunches for your children, complete
the attached application and return it to the school. Within days of receiving
your application, the school will let you know whether or not your children are eli­gible.
If you do not agree with the school's decision you have a right to a fair hear-ing.
This can be done by callir1g or writing (name, address, phone)
In certain cases foster children are also eligible for these benefits. If you have foster
children living with you and wish to apply for such lunches for them, please notify
us or indicate it on the application.
All children are treated the same regardless of ability to pay. In the operation of
child feeding programs, no child will be discriminated against because of race, sex,
color, or national origin.
If we can be of any further assistance or if your income changes during the year,
please contact us.
Sincerely,
(name)
(title)
38
Lunch only, with no
reduced-price meals
APPLICATION
APPLICATION J
Date _____ _
Parents: To apply for free lunches for your children, fill out this form and return
it to the school office.
Names and grades of children for whom application is made:
Name and address of parent or guardian:
Total number in family: ___ _
Total family income before deductions. Include wages of all working members, wel­fare
payments, pensions, social security, and all other income. Fill in one: Yearly
___ Monthly Weekly ___________________ _
If your gross family income exceeds the amount indicated in the attached family in­come
scale and you wish to apply under any of the special hardship conditions cited
in the attached letter, please complete theapplication form and also describe the na­ture
of your hardship here: ------------------------
In certain cases foster children are eligible for free lunches regardless of your fam­ily
income. If you have foster children living with you and wish to apply for such
lunches for them, please check here: __
I hereby certify that all of the above information is true and correct to the best of
my knowledge and belief.
Signature of adult family member
FOR SCHOOL USE ONLY
Your application for free lunches for your children has been:
____ Approved for free lunches.
____ Denied for the following reason:
You may appeal this decision by calling or writing (name and title)
at (address and phone number) ----'--------'---
39
I Breakfast only, with
reduced-price meals
Dear Parent or Guardian:
LETTER K
The School serves nutritious breakfasts every
scheol day. Students may buy breakfast for cents.
Children from families whose income is at or below the levels shown on the attached
scale are eligible for breakfast free or at the reduced price of cents. If your
income is greater than those shown but you have unusually high medical bills, shelter
costs in excess of 30 percent of your income, special education expenses due to the
mental or physical condition of a child, or disaster or casualty losses, your children
may still be eligible.
To apply at any time during the year, for free or reduced-price breakfasts for your
children, complete the attached application and return it to the school. Within __
days of receiving your application, the school will let you know whether or not your
children are eligible. If you do not agree with the school's decision you have a right
to a fair hearing. This can be done by calling or writing (name, address, phone).
In certain cases foster children are also eligible for these benefits. If you have foster
children living with you and wish to apply for such breakfasts for them, please
notify us or indicate it on the application.
All children are treated the same regardless of ability to pay. In the operation of
child feeding programs, no child will be discriminated against because of race, sex,
color, or national origin.
If we can be of any further assistance or if your income changes during the year,
please contact us.
Sincerely,
(name)
(title)
40
APPLICATION K
Breakfast only, with
reduced-price meals
APPLICATION
Date _____ _
Parents: To apply for free or reduced-price breakfasts for your children, fill out this
form and return it to the school office.
Names and grades of children for whom application is made: ________ _
N arne and address of parent or guardian :
Total number in family: ___ _
Total family income before deductions. Include wages of all working members, wel­fare
payments, pensions, social security, and all other income. Fill in one:
Yearly Monthly Weekly ___ _
If your gross family income exceeds the amouni indicated in the attached family in­come
scale and you wish to apply under any of the special hardship conditions cited
in the attached letter, please complete the application form and also describe the
nature of your hardship here: ----------------------
In certain cases foster children are eligible for free or reduced-price breakfasts re­gardless
of your family income. If you have ~oster children living with you and wish
to apply for such breakfasts for them, please check here: ___ _
I hereby certify that all of the above information is true and correct to the best of
my knowledge and belief.
Signature of adult family member
FOR SCHOOL USE ONLY
Your application for free or reduced-price breakfasts for your children has been:
---~Approved for free breakfasts.
____ Approved for reduced-price breakfasts at cents.
____ Denied for the following reason:
You may appeal this decision by calling or writing (name and title at
(address and phone number) ___ ..:...._ ______ _
41
LETTER L
Breakfast only, with
no reduced-price meals
Dear Parent or Guardian :
The School serves nutritious breakfasts every
school day. Students may buy breakfast for cents.
Children from families whose income is at or below the levels shown on the attached
scale are eligible for free breakfasts. If your income is greater than those shown but
you have unusually high medical bills, shelter costs in excess of 30 percent of your
income, special education expenses due to the mental or physical condition of a child,
or disaster or casualty losses, your children may still be eligible.
To apply at any time during the year for free breakfasts for your children, complete
the attached application and return it to the school. Within days of receiving
your application, the school will let you know whether or not your children are eli­gible.
If you do not agree with the school's decision you have a right to a fair hear-ing.
This can be done by calling or writing (name, address, phone)
In certain cases foster children are also eligible for these benefits. If yo~ have foster
children living with you and wish to apply for such breakfasts for them, please
notify us or indicate it on the application.
All children are treated the same regardless of ability to pay. In the operation of
child feeding programs, no child will be discriminated against because of race, sex,
color, or national origin.
If we can be of any further assistance or if your income changes during the year,
please contact us.
Sincerely,
(name)
(title)
42
APPLICATION L
Breakfast only, with
no reduced-price meals
APPLICATION
Date ____ _
Parents: To apply for free breakfasts for your children, fill out this form and re-­turn
it to the school office.
Names and grades of children for whom application is made:
Name and address of parent or guardian:
Total number in family: ___ _
Total family income before deductions. Include wages of all working members, wel­fare
payments, pensions, social security, and all other income. Fill in one:
Yearly Monthly Weekly ___ _
If your gross family income exceeds the amount indicated in the attached family in­come
scale and you wish to apply under any of the special hardship conditions cited
in the attached letter, please complete the application form and also describe the
nature of your hardship here: ------------------------
In certain cases foster children are eligible for free breakfasts regardless of your
family income. If you have foster children living with you and wish to apply for
such breakfasts for them, please check here: ___ _
I hereby certify that all of the above information is true and correct to the best of
my knowledge and belief.
Signature of adult family member
FOR SCHOOL USE ONLY
Your application for free breakfasts for your children has been:
Approved for free breakfasts.
____ Denied for the following reason:
You may appeal this decision by calling or writing (name and title)
at (address and phone number) ---....:.....-----~---
43 .
LETTERM
Milk only
Dear Parent or Guardian:
The --------------- School serves milk every school day. Stu-dents
may buy milk for ___ cents.
Children from families whose income is at or below the levels shown on the attached
scale are eligible for free milk. If your income is greater than those shown but you
have unusually high medical bills, shelter costs in excess of 30 percent of your income,
special education expenses due to the mental or physical condition of a child, or dis­aster
or casualty losses, your children may still be eligible.
To apply at any time during the year for free milk for your children, complete the at­tached
application and return it to the school. Within days of receiving your
application, the school will let you know whether or not your children are eligible. If
you do not agree with the school's decision you have a right to a fair hearing. This
.c an be done by calling or writing (name, address, phone)
In certain cases foster children are also eligible for these benefits. If you have foster
children living with you and wish to apply for free milk for them, please notify us
or indicate it on the application.
All children are treated the same regardless of ability to pay. In the operation of
child feeding programs, no child will be discriminated against because of race, sex,
color, or national origin.
If we can be of any further assistance or if your income changes during the year,
please contact us.
Sincerely,
(name)
(title)
44
APPLICATION M
Milk only
APPLICATION
Date _____ _
Parents: To apply for free milk for your children, fill out this form and return it
to the school office.
Names and grades of children for whom application is made: ________ _
Name and address of parent or guardian:
Total number in family: ___ _
Total family income before deductions. Include wages of all working members, wel­fare
payments, pensions, social security, and all other income. Fill_ in one:
Yearly Monthly Weekly ·
If your gross family income exceeds the amount indicated in the attached family in­come
scale and you wish to apply under any of the special hardship conditions cited
in the attached letter, please complete the application form and also describe the
nature of your hardship here:----------------------
In certain cases foster children are eligible for free milk regardless of your family
income. If you have foster children living with you and wish to apply for such
milk for them, please check here:
I hereby certify that all of the above infor:r~ation is true and correct to the best of
my knowledge and belief.
Signature of adult family member
FOR SCHOOL USE ONLY
Your application for free milk for your children has been:
____ Approved for free milk.
____ Denied for the following reason :
You may appeal this decision by calling or writing (name and title)
at (address and phone number) ---~ .................................... ...:..;;.;;~---
45
SAMPLE PUBLIC RELEASE
(Local school food authority) today announced its policy for (free and reduced­p1
·ice meals, /Tee milk) for children unable to pay the full price of meals and milk
served under the National School Lunch, School Breakfast, and Special Milk Pro­grams.
Local school officials have adopted the following family size income criteria for de­termining
eligibility:
'Childen from families whose income is at or below the levels shown are eligible
for (j?·ee or reduced-p1·ice meals · o1· free milk). In addition, families not meeting
these criteria but with other unusual expenses due to unusually high medical ex­penses,
shelter costs in excess of 30 percent of income, special education expenses
due to the mental or physical condition of a child, and disaster or casualty losses
are urged to apply.
Application forms are being sent to all homes in a letter to parents. Additional
copies are available at the principal's office in each school. The information pro­vided
on the application is confidential and will be used only for the purpose of
determining eligibility. Applications may be submitted at any time during the year.
In certain cases foster children are also eligible for these benefits. If a family has
foster children living with them and wishes to apply for such meals and milk for
them, it should contact the school.
In the operation of child feeding programs, no child will be discriminated against
because of race, sex, color, or national origin.
Under the provisions of the policy (title of dete1·mining official) will review appli­cations
and determine eligibility. If a parent is dissatisfied with the ruling of the
official, he may make a request either orally or in writing to (name, add1·ess, phone
of the hearing official) for a hearing to appeal the decision. The policy contains an
outline of the hearing procedure.
~
Each school and the office of the (central office) has a copy of the complete policy
which may be reviewed by any interested party.
46
SAMPLE COLLECTION PROCEDURES
In collecting payments for meals and milk and in distributing tickets, tokens, etc.,
school officials must ensure that there is no overt identification of recipients of
free or reduced-price meals and free milk. Care must be taken to prevent such
identification at the time the ticket or token is issued as well as in the serving line.
Any collection system should have a built-in accounting system to record the num­bers
of full-price, reduced-price, and free meals and the quantities of full-price and
free milk served daily. Keeping these counts is a regulatory requirement.
The following collection methods have been effectively employed across the nation.
They can be used equally well in the National School Lunch, School Breakfast,
and Special Milk Programs. Some of them require ticket or token coding. Various
methods for coding are discussed below.
-Before school, children can buy tickets at the cafeteria manager's office but
they do not receive the tickets. The cafeteria manager sends the purchased tickets
as well as tickets for free meals and milk recipients to the classroom each day. The
teacher distributes the tickets just before meal time. The tickets are coded for ac­counting
purposes.
-Students pay for their meals in the office. A check-off list, including the names
of all children eating (full-price, reduced-price, and free) is then prepared and
sent to the cafeteria. A cashier familiar with the student body checks off names
as children pass through the line. At the end of the meal service the list is returned
to the office for accounting purposes. This method will only work in a relatively
small school in which one person is familiar with the entire student body.
-The homeroom teacher provides each child with an envelope for daily, weekly,
or monthly payments. Pupils return the envelopes with payment if paying full or
reduced price, or empty if free. The envelopes are collected in the school office and
coded tickets are issued to every participating student.
-Parents pay in advance by the month. Each teacher receives a list of those chil­dren
who have paid. Those children who who receive free meals or milk are marked
paid, so no one but the bookkeeper knows which children receive a free meal or
milk. Teachers keep daily records of each child served.
-Meal payments are collected in the school secretary's office. Payments can be
made by children or parents on a daily, weekly, or monthly basis. The secretary
records payments and knows which children qualify for free meals or free milk.
Identical tickets labeled only with the children's names are distributed in the class­rooms
by the secretary.
Since parents may make payments, even children who receive free meals or milk
may not know whether their meals or milk are free, reduced-priced or full-price.
47
-Parents are billed monthly for full-priced or reduced-price meals their children
are served. All payments are mailed in so that no money is collected in classrooms.
All participating students receive a monthly ticket which is punched each time the
student eats. At the end of the month the tickets are collected and a clerk calcu­lates
the amount to be billed.
CODING METHODS:
-Number coding. Free meal or milk tickets may all have a four digit number,
reduced-price tickets have a five digit number, and full-price tickets have a six
digit number.
-Number coding by series. Numbers 1 through 1,999 may be free meal or milk
tickets, numbers 2,000 through 3,999 may be reduced-price tickets, and number
4,000 through 5,999 may be full-price tickets.
-Number coding-even and odd. If no reduced-price meals are offered, all even
numbers may be free and all odd numbers may be full-price.
-Names. Tickets may have the child's name on them and can later be compared
to a checklist.
-Date stamp. Tickets may have the date stamped on them in different spots. For
instance, tickets with the date stamped in the top third may be full-price, tickets
stamped in the middle third are free, and tickets stamped on the bottom are
reduced-price.
48
•
Policy
Checklist
If you develop your own policy
you should compare it to the
checklist in this section to en­sure
that it contains all the
necessary elements .
FREE AND REDUCED-PRICE POLICY CHECKLIST
If you develop your own policy, letter to parents, public release; or application, you
should check it against this list to ensure that it contains all the items required.
POLICY STATEMENT MUST CONTAIN:
-Reference to all programs in which you participate-breakfast, lunch, milk.
-Reference to free meals; also to reduced-price meals only if you offer both of
these benefits. ,
- Title of official designated to make the eligibility determinations.
- Family size and income criteria to determine eligibility, including the four speci-fied
hardship provisions and the foster children p!"ovision.
-Application procedure.
-Description of collection procedure (s).
- Nondiscrimination assurances.
-Assurance that application will be accepted at any time during the school year.
-Assurance that free and reduced-price meal and free milk recipients may trans-fer
eligibility within school district.
-Assurance that all ·children in the same family will receive the same benefits.
- Statement that policy will be announced by means of a letter to parents.
-Assurance that the same information outlined in the parent letter will be sub-mitted
to the informational media.
-Assurance that if lunch, breakfast, and milk are served, eligibility criteria are
the same.
-Complete hearing procedure.
-Assurance that recipients of free and reduced-price meals and free milk will con-tinue
to receive benefits during the time an appeal is pending.
- Copy of public release.
-Copy of application.
-Copy of letter to parents.
-Copy of family-size income scale.
-Copy of collection procedure (s).
THE LETTER TO PARENTS MUST:
-Contain complete eligibility criteria, including the four specified hardship condi-tions
and statement of possible eligibility of foster children.
-Indicate that an application is included.
- Provide instructions for submitting an application.
-Tell how to appeal (oral/written).
-Tell where to appeal.
-Give the reduced price for lunch and for breakfast when reduced-price meals are
offered.
- Contain the statement: "In the operation of child feeding programs, no child will
be discriminated against because or race, sex, color, or national origin."
50
APPLICATION FORM MUST:
-Be clear and simple and request only information required to determine eligibil­ity:
number in family, family income, certification of true and accurate informa­tion,
and signature of adult family member.
-Tell where to submit application.
- Include the statement: "In certain cases foster children are eligible for free or
reduced-price meals and free milk regardless of family income. If you have foster .
children living with you and wish to apply for such meals for them, please con­tact
us."
- Include the statement: "If your gross family income exceeds the amount indi­cated
in the family income scale as shown and you wish to apply for free or
reduced-price meals and free milk for your children under any of the special hard­ship
conditions cited in the letter, please complete this application form and also
describe the nature of your hardship."
PUBLIC RELEASE MUST CONTAIN:
-Eligibility criteria, including the four specified hardship conditions and the state-ment
of possible eligibility of foster children.
- Instructions for obtaining applications.
- Instructions for appeal (oral/written).
- Nondiscrimination statement.
COLLECTION PROCEDURE(S) MUST:
-Prevent overt identification of children receiving free or reduced-price meals and
free milk at the time meal is served.
- Prevent overt identification of children receiving free or reduced-price meals and
free milk at the time the medium of exchange (ticket, token, etc.) is obtained.
51
•
Addendum
If you serve an area with high
concentrations of parents who
do not speak English, you
should develop the letters to
parents and applications in
the language of the people.
This section contains the pa­rent
letter and application in
Spanish. This section also in­cludes
an application adapted
for school systems which use
computers .
Para uso en las escuelas que sirven leche gratis y
que sirven comidas gratis y a precios reducidos.
Informacion por los padres o guardianes de los estudiantes de ( escuela)
La escuela sirve comidas alimenticias
diariamente durante los dias escolares. Los estudiantes pueden comprar el almuerzo
por centavos, el desayuno por centavos, y leche suplementaria por
___ centavos.
Niiios de familias cuyos ingresos son a nivel o bajo el nivel segun Ia escala que le
incluirnos, califican para obtener leche gratis y comidas gratis o a . precio reducido
a ___ centavos por el almuerzo y a centavos por el desayuno. Si un in-greso
es mayor que lo que se indica, aun sus hijos pueden ser elegibles bajo las siguien­tes
condiciones. Si usted tiene cuentas medicas en exceso, gasto de domicilio que
excede treinte por ciento de su ingreso, gasto en educaci6n especializada pat~a su hijo
por causa de una incapacidad fisica o mental, o perdidas accidentales a consecuencia
de desastres.
Para aplicar a cualquier tiempo durante el aiio por leche gratis y comidas gratis o
a precio reducido para sus hijos, favor de completar Ia aplicaci6n adjunta y remi­tirla
a Ia escuela.
La escuela se tomara dias en contestarle al respecto informandole si sus
hi.ios son elegibles. Si usted no accepta Ia decision elegada, tiene derecho a solicitar
para una audiencia. Para ello, sirvase escribir a Sr (a) (nombre, direcci6n), o
!lame al ( telefono)
Hay casos en que niiios al cuidado de una familia, califican para estos beneficios.
Si tiene tales niiios en su residencia y desea que estos niiios participen en las comi­das
y Ia leche, favor de indicarlo en Ia aplicaci6n.
A todos los niiios se les trata igual, no importa si paguen o no. En los programas de
alimentaci6n escolar los niiios no se seran descriminados a causa de su raza, sexo,
color, u origen de nacionalidad.
Tenga Ia bondad de notificarnos en caso de algun cambio en sus ingresos, o si le
podemos servir en algo mas.
Sinceramen te,
(nombre)
(titulo)
54
Para uso en las escuelas que sirven leche gratis y
que sirven comidas gratis y a precios reducidos.
APLICACION
Fecha ____ _
Padres: Llene este formulario para aplicar por leche gratis y comidas gratis o a
precio reducidos para sus nifios y devuelvelo a Ia oficina de Ia escuela.
N ombre y grado de los nifios para quien Ia aplicaci6n se hace:
N ombre y direcci6n de padres o guardian :
N umero de miembros en Ia familia : _____ _
Total de ingresos antes de deducci6nes: Incluya sueldos de todos los miembros de
la familia que trabajan, pagos de beneficencia, pensiones, seguro social, y toda entrada
de dinero. Llene uno :
Anual $ Mensual $ Semanal $ _____ _
Si su ingreso total excede la cantidad indicada en la escala adjunta y usted desea
aplicar bajo una de las condiciones especiales nombradas anteriormente en la carta,
favor de completar este formulario y describa en detalle la condici6n o condiciones
de su dificultad: ----------------------------
Hay casos en que nmos al cuidado de una familia califican para obtener leche
gratis y comidas gratis o a precio reducidos; no importa el ingreso de la familia.
Si tiene tales nifios en su casa y desea que participen en las comidas y la leche, favor
de indicar aqui: _________ _
Certifico que toda la informacion dada en este formulario es la verdad, correcta y
de acuerdo con mi mejor creencia.
Firma (jefe de la familia)
PARA USO SOLAMENTE POR LA ESCUELA:
Su aplicaci6n para obtener leche gratis y comidas gratis o a precios reducidos para
sus nifios ha sido:
____ Aprobadaj comidas gratis y leche gratis.
____ Aprobada/ comidas a precios reducidos a centavos para al-muerzo
y a centavos para desayuno.
____ Rehusado. Raz6n por la cual: -----------------
Usted puede apelar esta decision. Para ello, sirvase escribir a (nombre, titulo official
de audiencias, direcci6n), o llame al ( telefono).
55
en
G) TO PARENT:
To apply for free or reduced-price meals and free milk for your children, fill out
the form on the reverse side and return it to the school office.
If your gross family income exceeds the amount indicated in the family income
scale and you wish to apply under any of the hardship conditions cited in the letter,
please complete the entire application including the hardship section.
In certain cases foster children are eligible for free or reduced-price meals and free
milk regardless of your family income. If you have such children living with you
and wish to apply for such meals for them, please check the appropriate box on the
reverse side.
Please sign here certifying that all of the information on the reverse side is true
and correct to the best of your knowledge and belief.
Signature of the Adult Family Member ____________ _
(month, day, year)
School Code Number [. -J ,. I I
Names of children for whom application is made:
(skip one block between last and first)
Last First
Date I I I I I I I
Total number in family OJ
Income of family before deductions:
Monthly (dollars-no cents) lr--"'TI-'1-1.---...,1
Check here if you wish to apply
under hardship conditions: D
Check here if you have foster D
children living with you:
If you checked the hardship box, what is
your hardship?----------