Letter to Parents for School Meal Programs

Transcription

1 Letter t Parents fr Schl Meal Prgrams Dear Parent/Guardian: Children need healthy meals t learn. Canastta Central Schl District ffers healthy meals every schl day. Breakfast csts $1.10 fr K- 12; lunch csts $2.05 fr Peterbr St. and Suth Side Elementary;$2.25 fr Rberts Street Elementary and Canastta Jr. & Sr. High Schl. Yur children may qualify fr free meals r fr reduced price meals. Reduced price is $0.25 fr breakfast and $0.25 fr lunch. 1. DO I NEED TO FILL OUT AN APPLICATION FOR EACH CHILD? N. Cmplete the applicatin t apply fr free r reduced price meals. Use ne Free and Reduced Price Schl Meals Applicatin fr all students in yur husehld. We cannt apprve an applicatin that is nt cmplete, s be sure t fill ut all required infrmatin. Return the cmpleted applicatin t Ms. Christina Omans, Canastta Central Schl District, Fd Service Dept., 101 Rberts Street, Canastta, NY Phne# WHO CAN GET FREE MEALS? All children in husehlds receiving benefits frm SNAP, the Fd Distributin Prgram n Indian Reservatins r TANF, can get free meals regardless f yur incme. Als, yur children can get free meals if yur husehld s grss incme is within the free limits n the Federal Incme Eligibility Guidelines. 3. CAN FOSTER CHILDREN GET FREE MEALS? Yes, fster children that are under the legal respnsibility f a fster care agency r curt, are eligible fr free meals. Any fster child in the husehld is eligible fr free meals regardless f incme. 4. CAN HOMELESS, RUNAWAY, AND MIGRANT CHILDREN GET FREE MEALS? Yes, children wh meet the definitin f hmeless, runaway, r migrant qualify fr free meals. If yu haven t been tld yur children will get free meals, please call r Ms. Christina Omans at , r tmans@mbces.rg t see if they qualify. 5. WHO CAN GET REDUCED PRICE MEALS? Yur children can get lw cst meals if yur husehld incme is within the reduced price limits n the Federal Eligibility Incme Chart, shwn n this applicatin. 6. SHOULD I FILL OUT AN APPLICATION IF I RECEIVED A LETTER THIS SCHOOL YEAR SAYING MY CHILDREN ARE APPROVED FOR FREE MEALS? Please read the letter yu gt carefully and fllw the instructins. Call the schl at if yu have questins. 7. MY CHILD S APPLICATION WAS APPROVED LAST YEAR. DO I NEED TO FILL OUT ANOTHER ONE? Yes. Yur child s applicatin is nly gd fr that schl year and fr the first 30 perating days f this schl year. Yu must send in a new applicatin unless the schl tld yu that yur child is eligible fr the new schl year. 8. I GET WIC. CAN MY CHILD(REN) GET FREE MEALS? Children in husehlds participating in WIC may be eligible fr free r reduced price meals. Please fill ut a FREE/REDUCED PRICE MEAL applicatin. 9. WILL THE INFORMATION I GIVE BE CHECKED? Yes and we may als ask yu t send written prf. 10. IF I DON T QUALIFY NOW, MAY I APPLY LATER? Yes, yu may apply at any time during the schl year. Fr example, children with a parent r guardian wh becmes unemplyed may becme eligible fr free and reduced price meals if the husehld incme drps belw the incme limit. 11. WHAT IF I DISAGREE WITH THE SCHOOL S DECISION ABOUT MY APPLICATION? Yu shuld talk t schl fficials. Yu als may ask fr a hearing by calling r writing t: Ms.Christina Omans, Fd Service Directr, Canastta Central Schl, 101 Rberts Street, Canastta, NY r MAY I APPLY IF SOMEONE IN MY HOUSEHOLD IS NOT A U.S. CITIZEN? Yes. Yu r yur child(ren) d nt have t be U.S. citizens t qualify fr free r reduced price meals. 13. WHO SHOULD I INCLUDE AS MEMBERS OF MY HOUSEHOLD? Yu must include all peple living in yur husehld, related r nt (such as grandparents, ther relatives, r friends) wh share incme and expenses. Yu must include yurself and all children living with yu. If yu live with ther peple wh are ecnmically independent (fr example, peple wh yu d nt supprt, wh d nt share incme with yu r yur children, and wh pay a pr-rated share f expenses), d nt include them. 14. WHAT IF MY INCOME IS NOT ALWAYS THE SAME? List the amunt that yu nrmally receive. Fr example, if yu nrmally make $1000 each mnth, but yu missed sme wrk last mnth and nly made $900, put dwn that yu made $1000 per mnth. If yu nrmally get vertime, include it, but d nt include it if yu nly wrk vertime smetimes. If yu have lst a jb r had yur hurs r wages reduced, use yur current incme. 15. WE ARE IN THE MILITARY. DO WE INCLUDE OUR HOUSING ALLOWANCE AS INCOME? If yu get an ff-base husing allwance, it must be included as incme. Hwever, if yur husing is part f the Military Husing Privatizatin Initiative, d nt include yur husing allwance as incme. 16. MY SPOUSE IS DEPLOYED TO A COMBAT ZONE. IS HER COMBAT PAY COUNTED AS INCOME? N, if the cmbat pay is received in additin t her basic pay because f her deplyment and it wasn t received befre she was deplyed, cmbat pay is nt cunted as incme. Cntact yur schl fr mre infrmatin. 17. MY FAMILY NEEDS MORE HELP. ARE THERE OTHER PROGRAMS WE MIGHT APPLY FOR? T find ut hw t apply fr SNAP r ther assistance benefits, cntact yur lcal assistance ffice r call

2 INCOME ELIGIBILITY GUIDELINES FOR FREE AND REDUCED PRICE MEALS OR FREE MILK REDUCED PRICE ELIGIBILITY INCOME CHART Ttal Family Size Annual Mnthly Twice per Mnth Every Tw Weeks Weekly 1 $ 22,311 $ 1,860 $ 930 $ 859 $ $ 30,044 $ 2,504 $ 1,252 $ 1,156 $ $ 37,777 $ 3,149 $ 1,575 $ 1,453 $ $ 45,510 $ 3,793 $ 1,897 $ 1,751 $ $ 53,243 $ 4,437 $ 2,219 $ 2,048 $ 1,024 6 $ 60,976 $ 5,082 $ 2,541 $ 2,346 $ 1,173 7 $ 68,709 $ 5,726 $ 2,863 $ 2,643 $ 1,322 8 $ 76,442 $ 6,371 $ 3,186 $ 2,941 $ 1,471 *Each additinal persn add $ 7,733 $ 645 $ 323 $ 298 $ 149 Hw t Apply: T get free r reduced price meals fr yur children carefully cmplete ne applicatin fr yur husehld and return it t the designated ffice. If yu nw receive Supplemental Nutritin Assistance Prgram (SNAP), Temprary Assistance t Needy Families (TANF) fr any children, r participate in the Fd Distributin Prgram n Indian Reservatins (FDPIR), the applicatin must include the children's names, the husehld SNAP, TANF r FDPIR case number and the signature f an adult husehld member. All children shuld be listed n the same applicatin. If yu d nt list a SNAP, TANF r FDPIR case number, the applicatin must include the names f everyne in the husehld, the amunt f incme each husehld member, and hw ften it is received and where it cmes frm. It must include the signature f an adult husehld member and the last fur digits f that adult's scial security number, r check the bx if the adult des nt have a scial security number. An applicatin that is nt cmplete cannt be apprved. Cntact yur lcal Department f Scial Services fr yur SNAP r TANF case number r cmplete the incme prtin f the applicatin. Reprting Changes: The benefits that yu are apprved fr at the time f applicatin are effective fr the entire schl year. Yu n lnger need t reprt changes fr an increase in incme r decrease in husehld size, r if yu n lnger receive SNAP. Incme Exclusins: The value f any child care prvided r arranged, r any amunt received as payment fr such child care r reimbursement fr csts incurred fr such care under the Child Care Develpment (Blck Grant) Fund shuld nt be cnsidered as incme fr this prgram. Nndiscriminatin Statement: This explains what t d if yu believe yu have been treated unfairly. In accrdance with Federal civil rights law and U.S. Department f Agriculture (USDA) civil rights regulatins and plicies, the USDA, its Agencies, ffices, and emplyees, and institutins participating in r administering USDA prgrams are prhibited frm discriminating based n race, clr, natinal rigin, sex, disability, age, r reprisal r retaliatin fr prir civil rights activity in any prgram r activity cnducted r funded by USDA. Persns with disabilities wh require alternative means f cmmunicatin fr prgram infrmatin (e.g. Braille, large print, auditape, American Sign Language, etc.), shuld cntact the Agency (State r lcal) where they applied fr benefits. Individuals wh are deaf, hard f hearing r have speech disabilities may cntact USDA thrugh the Federal Relay Service at (800) Additinally, prgram infrmatin may be made available in languages ther than English. T file a prgram cmplaint f discriminatin, cmplete the USDA Prgram Discriminatin Cmplaint Frm, (AD-3027) fund nline at: and at any USDA ffice, r write a letter addressed t USDA and prvide in the letter all f the infrmatin requested in the frm. T request a cpy f the cmplaint frm, call (866) Submit yur cmpleted frm r letter t USDA by: (1) mail: U.S. Department f Agriculture Office f the Assistant Secretary fr Civil Rights 1400 Independence Avenue, SW Washingtn, D.C ; (2) fax: (202) ; r (3) prgram.intake@usda.gv. This institutin is an equal pprtunity prvider. 2

3 Meal Service t Children With Disabilities: Federal regulatins require schls and institutins t serve meals at n extra charge t children with a disability which may restrict their diet. A student with a disability is defined in 7CFR Part 15b.3 f Federal regulatins, as ne wh has a physical r mental impairment which substantially limits ne r mre majr life activities. Majr life activities are defined t include functins such as caring fr ne s self, perfrming manual tasks, walking, seeing, hearing, speaking, breathing, learning, and wrking. Yu must request the special meals frm the schl and prvide the schl with medical certificatin frm a medical dctr. If yu believe yur child needs substitutins because f a disability, please get in tuch with us fr further infrmatin, as there is specific infrmatin that the medical certificatin must cntain. Cnfidentiality: The United States Department f Agriculture has apprved the release f students names and eligibility status, withut parent/guardian cnsent, t persns directly cnnected with the administratin r enfrcement f federal educatin prgrams such as Title I and the Natinal Assessment f Educatinal Prgress (NAEP), which are United States Department f Educatin prgrams used t determine areas such as the allcatin f funds t schls, t evaluate sciecnmic status f the schl's attendance area, and t assess educatinal prgress. Infrmatin may als be released t State health r State educatin prgrams administered by the State agency r lcal educatin agency, prvided the State r lcal educatin agency administers the prgram, and federal State r lcal nutritin prgrams similar t the Natinal Schl Lunch Prgram. Additinally, all infrmatin cntained in the free and reduced price applicatin may be released t persns directly cnnected with the administratin r enfrcement f prgrams authrized under the Natinal Schl Lunch Act (NSLA) r Child Nutritin Act (CNA); including the Natinal Schl Lunch and Schl Breakfast Prgrams, the Special Milk Prgram, the Child and Adult Care Fd Prgram, Summer Fd Service Prgram and the Special Supplemental Nutritin Prgram fr Wmen Infants and Children (WIC); the Cmptrller General f the United States fr audit purpses, and federal, State r lcal law enfrcement fficials investigating alleged vilatin f the prgrams under the NSLA r CNA. Reapplicatin: Yu may apply fr benefits any time during the schl year. Als, if yu are nt eligible nw, but during the schl year becme unemplyed, have a decrease in husehld incme, r an increase in family size yu may request and cmplete an applicatin at that time. The disclsure f eligibility infrmatin nt specifically authrized by the NSLA requires a written cnsent statement frm the parent/guardian. We will let yu knw when yur applicatin is apprved r denied. Sincerely, Christina Omans Fd Service Directr 3

4 FREE AND REDUCED PRICE MEAL APPLICATION FACT SHEET When filling ut the applicatin frm, please pay careful attentin t these helpful hints. SNAP/TANF/FDPIR case number: This must be the cmplete valid case number supplied t yu by the agency including all numbers and letters, fr example, E123456, r whatever cmbinatin is used in yur cunty. Refer t a letter yu received frm yur lcal Department f Scial Services fr yur case number r cntact them fr yur number. Fster Child: A child wh is living with a family but wh is under the legal care f the welfare agency r curt may be listed n yur family applicatin. List the child's persnal use incme. This includes nly thse funds prvided by the agency which are identified fr the persnal use f the child, such as persnal spending allwances, mney received by his/her family, r frm a jb. Funds prvided fr husing, fd and care, medical, and therapeutic needs are nt cnsidered incme t the fster child. Write 0 if the child has n persnal use incme. Husehld: A grup f related r nn-related peple wh are living in ne huse and share incme and expenses. Adult Family Members: All related and nn-related peple wh are 21 years f age and lder living in yur huse. Financially Independent: A persn is financially independent and a separate ecnmic unit/husehld when his r her earnings and expenses are nt shared by the family/husehld. Current Grss Incme: Mney earned r received at the present time by each member f yur husehld befre deductins. Examples f deductins are federal tax, State tax, and Scial Security deductins. If yu have mre than ne jb, yu must list the incme frm all jbs. If yu receive incme frm mre than ne surce (wage, alimny, child supprt, etc.), yu must list the incme frm all surces. Only farmers, self-emplyed wrkers, migrant wrkers, and ther seasnal emplyees may use their incme fr the past 12 mnths reprted frm their 1040 Tax Frms. Examples f grss incme are: Wages, salaries, tips, cmmissins, r incme frm self-emplyment Net farm incme grss sales minus expenses nly nt lsses Pensins, annuities, r ther retirement incme including Scial Security retirement benefits Unemplyment cmpensatin Welfare payments (des nt include value f SNAP) Public Assistance payments Adptin assistance Supplemental Security Incme (SSI) r Scial Security Survivr's Benefits Alimny r child supprt payments Disability benefits, including wrkman's cmpensatin Veteran's subsistence benefits Interest r dividend incme Cash withdrawn frm savings, investments, trusts, and ther resurces which wuld be available t pay fr a child's meals Other cash incme Incme Exclusins: The value f any child care prvided r arranged, r any amunt received as payment fr such child care r reimbursement fr csts incurred fr such care under the Child Care Develpment (Blck Grant) Fund shuld nt be cnsidered as incme fr this prgram. If yu have any questins r need help in filling ut the applicatin frm, please cntact: Name: Ms. Tena Omans FdService Directr Telephne Number:

5 Date Withdrew Canastta Central Schl District F R D Applicatin fr Free and Reduced Price Schl Meals/Milk T apply fr free and reduced price meals fr yur children, read the instructins n the back, cmplete nly ne frm fr yur husehld, sign yur name and return it t the address listed belw. Call , if yu need help. Additinal names may be listed n a separate paper. Return Cmpleted Applicatins t: 1. List all children in yur husehld wh attend schl: Canastta Jr. & Sr. High Schl Ms. Tena Omans 101 Rberts Street Canastta, NY Student Name Schl Grade/Teacher Fster Child Hmeless Migrant, Runaway 2. SNAP/TANF/FDPIR Benefits: If anyne in yur husehld receives either SNAP, TANF r FDPIR benefits, list their name and CASE # here. Skip t Part 4, and sign the applicatin. Name: CASE #: 3. Reprt all incme fr ALL Husehld Members (Skip this step if yu answered yes t step 2) All Husehld Members (including yurself and all children that have incme). List all Husehld members nt listed in Step 1 (including yurself) even if they d nt receive incme. Fr each Husehld Member listed, if they d receive incme, reprt ttal incme fr each surce in whle dllars nly. If they d nt receive incme frm any ther surce, write 0. If yu enter 0 r leave any fields blank, yu are certifying (prmising) that there is n incme t reprt. Name f husehld member Earnings frm wrk befre deductins Amunt / Hw Often Child Supprt, Alimny Amunt / Hw Often Pensins, Retirement Payments Amunt / Hw Often Other Incme, Scial Security Amunt / Hw Often N Incme Ttal Husehld Members (Children and Adults) $ / $ / $ / $ / $ / $ / $ / $ / $ / $ / $ / $ / $ / $ / $ / $ / $ / $ / $ / $ / *Last Fur Digits f Scial Security Number: XXX-XX- *When cmpleting sectin 3, an adult husehld member must prvide the last fur digits f their Scial Security Number (SS#), r mark the I d nt have a SS# bx befre the applicatin can be apprved. 4. Signature: An adult husehld member must sign this applicatin befre it can be apprved. I certify (prmise) that all the infrmatin n this applicatin is true and that all incme is reprted. I understand that the infrmatin is being given s the schl will get federal funds; the schl fficials may verify the infrmatin and if I purpsely give false infrmatin, I may be prsecuted under applicable State and federal laws, and my children may lse meal benefits. Signature: Date: Address: Hme Phne: Wrk Phne: Hme Address: 5. Ethnicity and Race are ptinal; respnding t this sectin des nt affect yur children s eligibility fr free r reduced price meals. Ethnicity: Hispanic r Latin Nt Hispanic r Latin Race: American Indian r Alaskan Native Asian Black r African American Native Hawaiian r Other Pacific Island DO NOT WRITE BELOW THIS LINE FOR SCHOOL USE ONLY Annual Incme Cnversin (Only cnvert when multiple incme frequencies are reprted n applicatin) Weekly X 52; Every Tw Weeks (bi-weekly) X 26; Twice Per Mnth X 24; Mnthly X 12 White SNAP/TANF/Fster Incme Husehld: Ttal Husehld Incme/Hw Often: / Husehld Size: Free Meals Reduced Price Meals Denied/Paid Signature f Reviewing Official Date Ntice Sent: I d nt have a SS#

6 APPLICATION INSTRUCTIONS T apply fr free and reduced price meals cmplete nly ne applicatin fr yur husehld using the instructins belw. Sign the applicatin and return the applicatin t Ms. Tena Omans, Canastta Jr. & Sr. High Schl, 101 Rberts Street, Canastta, NY If yu have a fster child in yur husehld, yu may include them n yur applicatin. A separate applicatin is n lnger needed. Call the schl if yu need help: Ensure that all infrmatin is prvided. Failure t d s may result in denial f benefits fr yur child r unnecessary delay in apprving yur applicatin. PART 1 ALL HOUSEHOLDS MUST COMPLETE STUDENT INFORMATION. DO NOT FILL OUT MORE THAN ONE APPLICATION FOR YOUR HOUSEHOLD. (1) Print the names f the children, including fster children, fr whm yu are applying n ne applicatin. (2) List their grade and schl. (3) Check the bx t indicate a fster child living in yur husehld, r if yu believe any child meets the descriptin fr hmeless, migrant, runaway (a schl staff will cnfirm this eligibility). PART 2 HOUSEHOLDS GETTING SNAP, TANF OR FDPIR SHOULD COMPLETE PART 2 AND SIGN PART 4. (1) List a current SNAP, TANF r FDPIR (Fd Distributin Prgram n Indian Reservatins) case number f anyne living in yur husehld. The case number is prvided n yur benefit letter. (2) An adult husehld member must sign the applicatin in PART 4. SKIP PART 3. D nt list names f husehld members r incme if yu list a SNAP case number, TANF r FDPIR number. PART 3 ALL OTHER HOUSEHOLDS MUST COMPLETE THESE PARTS AND ALL OF PART 4. (1) Write the names f everyne in yur husehld, whether r nt they get incme. Include yurself, the children yu are applying fr, all ther children, yur spuse, grandparents, and ther related and unrelated peple in yur husehld. Use anther piece f paper if yu need mre space. (2) Write the amunt f current incme each husehld member receives, befre taxes r anything else is taken ut, and indicate where it came frm, such as earnings, welfare, pensins and ther incme. If the current incme was mre r less than usual, write that persn s usual incme. Specify hw ften this incme amunt is received: weekly, every ther week (bi-weekly), 2 x per mnth, mnthly. If n incme, check the bx. The value f any child care prvided r arranged, r any amunt received as payment fr such child care r reimbursement fr csts incurred fr such care under the Child Care and Develpment Blck Grant, TANF and At Risk Child Care Prgrams shuld nt be cnsidered as incme fr this prgram. (3) Enter the ttal number f husehld members in the bx prvided. This number shuld include all adults and children in the husehld and shuld reflect the members listed in PART 1 and PART 3. (4) The applicatin must include the last fur digits nly f the scial security number f the adult wh signs PART 4 if Part 3 is cmpleted. If the adult des nt have a scial security number, check the bx. If yu listed a SNAP, TANF r FDPIR number, a scial security number is nt needed. (5) An adult husehld member must sign the applicatin in PART 4. OTHER BENEFITS: Yur child may be eligible fr benefits such as Medicaid r Children s Health Insurance Prgram (CHIP). T determine if yur child is eligible, prgram fficials need infrmatin frm yur free and reduced price meal applicatin. Yur written cnsent is required befre any infrmatin may be released. Please refer t the attached parent Disclsure Letter and Cnsent Statement fr infrmatin abut ther benefits. USE OF INFORMATION STATEMENT Use f Infrmatin Statement: The Richard B. Russell Natinal Schl Lunch Act requires the infrmatin n this applicatin. Yu d nt have t give the infrmatin, but if yu d nt submit all needed infrmatin, we cannt apprve yur child fr free r reduced price meals. Yu must include the last fur digits f the scial security number f the primary wage earner r ther adult husehld member wh signs the applicatin. The scial security number is nt required when yu apply n behalf f a fster child r yu list a Supplemental Nutritin Assistance Prgram (SNAP), Temprary Assistance fr Needy Families (TANF) Prgram r Fd Distributin Prgram n Indian Reservatins (FDPIR) case number r ther FDPIR identifier fr yur child r when yu indicate that the adult husehld member signing the applicatin des nt have a scial security number. We will use yur infrmatin t determine if yur child is eligible fr free r reduced price meals, and fr administratin and enfrcement f the lunch and breakfast prgrams. We may share yur eligibility infrmatin with educatin, health, and nutritin prgrams t help them evaluate, fund, r determine benefits fr their prgrams, auditrs fr prgram reviews, and law enfrcement fficials t help them lk int vilatins f prgram rules. DISCRIMINATION COMPLAINTS In accrdance with Federal civil rights law and U.S. Department f Agriculture (USDA) civil rights regulatins and plicies, the USDA, its Agencies, ffices, and emplyees, and institutins participating in r administering USDA prgrams are prhibited frm discriminating based n race, clr, natinal rigin, sex, disability, age, r reprisal r retaliatin fr prir civil rights activity in any prgram r activity cnducted r funded by USDA. Persns with disabilities wh require alternative means f cmmunicatin fr prgram infrmatin (e.g. Braille, large print, auditape, American Sign Language, etc.), shuld cntact the Agency (State r lcal) where they applied fr benefits. Individuals wh are deaf, hard f hearing r have speech disabilities may cntact USDA thrugh the Federal Relay Service at (800) Additinally, prgram infrmatin may be made available in languages ther than English. T file a prgram cmplaint f discriminatin, cmplete the USDA Prgram Discriminatin Cmplaint Frm, (AD-3027) fund nline at: and at any USDA ffice, r write a letter addressed t USDA and prvide in the letter all f the infrmatin requested in the frm. T request a cpy f the cmplaint frm, call (866) Submit yur cmpleted frm r letter t USDA by: (1) mail: U.S. Department f Agriculture Office f the Assistant Secretary fr Civil Rights 1400 Independence Avenue, SW Washingtn, D.C ; (2) fax: (202) ; r (3) prgram.intake@usda.gv. This institutin is an equal pprtunity prvider. 2