Dear Parent or Guardian: RE: Fee Waiver Application Process

Transcription

1 Dear Parent r Guardian: RE: Fee Waiver Applicatin Prcess The purpse f this crrespndence is t infrm yu f the schl district s prgrams fr free r reduced-price meals and waivers f schl fees fr the schl year. Fr thse interested in applying fr a fee waiver, applicatins must be submitted n later than Friday, July 7, Yur applicatin will be reviewed and yu will be ntified if yur applicatin has been apprved r denied n later than Mnday, July 10, T apply fr a fee waiver please prvide the fllwing: (1) a cmpleted applicatin frm (included in this mailing) AND (2) dcumentatin f yur husehld s grss incme. Fee Waiver applicatins may be mailed r drpped ff t Maine Suth High Schl n later than Friday, July 7, If yu want t drp ff yur materials in persn, please nte that materials must be drpped ff in the main ffice at Maine Suth High Schl anytime frm 7:30 a.m. t 3:30 p.m. Mnday thrugh Thursday. It is extremely imprtant that yu apply during this time perid. While applicatins will be accepted at any time, they are effective n the date that they are apprved and are nt retractive t the beginning f the schl year. Free/Reduced Price Meals: Maine Suth High Schl ffers healthy meals every schl day. Yur child/children may qualify fr free r reduced-price meals. The reduced-price meal is $1.00 fr breakfast and $1.75 fr lunch. Waiver f Schl Fees: The Bard f Educatin waives all schl fees assessed by the district fr a student s required participatin in any curricular r extracurricular prgram, as lng as the parent/guardian meets the eligibility. Schl fees are defined in the Bard s plicy as any mnetary charge cllected by the schl r district frm a student as a prerequisite fr the student s participatin in curricular and/r extracurricular prgrams f the schl r district. A schl des nt impse a fee when it requires a student t prvide his/her wn rdinary supplies r materials (pencil, paper, ntebk) Schl fees include, but are nt limited t, csts fr: All charges fr required textbks and instructinal materials; All charges and depsits cllected by a schl fr use f schl prperty (lcks, twels, ther general fees); Charges fr field trips made during schl hurs r after schl hurs if the field trip is a custmary part f a class;

2 Charges r depsits fr unifrms r equipment related t interschlastic athletics, teams rganized fr inter-schlastic participatin, intramurals r fine arts prgrams; Charges t participate in extra-curricular activities; Supplies required fr a particular class; Graduatin fees; Schl recrds fees; Driver educatin fees assessed pursuant t Sectin f The Schl Cde; Identificatin badge fee; Technlgy fee; Activity fee. Schl fees d nt include : Library fines and ther charges made fr the lss, misuse r destructin f schl prperty; Replacement cst f lst identificatin badge; Charges fr the purchase f class rings, yearbks, pictures r similar items; Charges fr ptinal travel undertaken by a schl club r grup f students utside f schl hurs; Charges fr admissin t schl dances, athletic events r ther scial events; Persnal items fr athletic/intramural/extracurricular events such as athletic shes, baseball glves, etc. With respect t the Applicatin Frm, please nte that that althugh there is a space n the Applicatin Frm fr yur Scial Security number, yu are nt required t prvide a Scial Security number if yu d nt have ne. Yu shuld check the bx indicating that yu d nt have a Scial Security number if yu d nt have ne. Nte that the District will nt use r share with a third party yur Scial Security number r infrmatin regarding yur lack f a Scial Security number fr any reasn unrelated t yur request fr free r reduced-price meals r a fee waiver. With respect t the dcumentatin f yur husehld s grss incme, yu must prvide ONE f the fllwing: All 2016 Federal tax returns (IRS Frm 1040) fr each wrking husehld member wh has such a frm, including cpies f all 1099s and W-2 s. Nte that the District will nt use r share with any third party yur tax frms r any infrmatin regarding yur lack f tax frms fr any reasn unrelated t yur request fr free r reduced-price meals r a fee waiver; OR Evidence f participatin in TANF (Temprary Assistance fr Needy Families) r Supplemental Nutritin Assistance Prgram (SNAP); OR Evidence the student is a fster child. OR If yu are unable t prvide any f the infrmatin listed abve, please cntact the Assciate Principal. Here are answers t questins yu may have abut applying under these methds: 1. D I need t fill ut an applicatin fr each child?

3 N. Use ne Husehld Eligibility 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. 2. Wh can get free/reduced meals and a schl fee waiver? Children in husehlds receiving Supplemental Nutritin Assistance Prgram (SNAP) r Temprary Assistance fr Needy Families (TANF) and fster children receive these items regardless f incme. Als, if yur husehld incme is within the limits n the Federal Incme Chart yur children are eligible. 3. My child s applicatin was apprved last year. D I need t fill ut anther ne? Yes. Yur child s applicatin is nly gd fr that schl year. 4. If I d nt qualify nw, may I apply later? Yes. Yu may apply at any time during the schl year. While applicatins will be accepted at any time, they are effective n the date that they are apprved and are nt retractive t the beginning f the schl year. 5. Wh shuld I include as members f my husehld? Yu must include all peple living in yur husehld, related r nt (such as grandparents, ther relatives, r friends). Yu must include yurself and all children wh live with yu. 6. 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 the enclsed applicatin. Illinis Revised Statutes, Chapter 38, Paragraph 17-6 prvides that supplying false infrmatin t btain a fee waiver is a Class 4 felny. We will review and verify the infrmatin yu submit. If yu prvide the requested dcumentatin, we shuld be able t tell yu immediately if yur fee waiver request has been granted r denied. If yur fee waiver request is denied, and yur family circumstances change, such as a decrease in husehld incme, an increase in husehld size, unemplyment r receiving fd stamps r TANF fr yur children, yu may reapply fr a waiver at any time during the schl year. If yur husehld incme increases r family size decreases, yu are bligated t reprt this change t my ffice immediately. A denial f a fee waiver request by the Assciate Principal may be appealed t the Assistant Superintendent f Business by submitting a written appeal within ten (10) schl days f the denial by the Assciate Principal. The Assistant Superintendent fr Business shall decide the parent s appeal within thirty (30) days f the receipt f the parent s written request fr appeal. The decisin f the Assistant Superintendent f Business is final and binding.

4 If yu have any questins regarding the free and reduced-price meals r fee waiver request prcess, please call the schl. Sincerely, Gerge A. Dagres Assciate Principal gdagres@maine207.rg Enclsure: Applicatin Instructins Free/Reduced Waiver Applicatin

5 Maine Twnship High Schl District FREE/REDUCED PRICE MEALS & FEE WAIVER APPLICATION INSTRUCTIONS T apply fr free and reduced-price meal services and/r fee waiver, cmplete the applicatin using these instructins. Sign the applicatin and return t the schl. (1) APPLICANT INFORMATION All Husehlds Cmplete Sectin (1). A. Print the name r names f the child(ren) yu are applying fr. B. List each child's student ID number. C. TANF case number-if applicable. List a current TANF case number r SNAP number fr each child. Attach a cpy f TANF/SNAP card(s) t applicatin. Link card number cannt be used. Skip t (6). D. Check if the applicatin is fr a fster child. Attach a cpy f the frnt and back f child s medical card. Skip t (6). (2) HOMELESS, MIGRANT, RUNAWAY OR HEAD START (Categrically eligible) A. Check bx (if applicable) f student n applicatin. B. Get crrespnding signature. G n t Sectin (3). (3) TOTAL HOUSEHOLD INCOME A. Write the names f everyne in yur husehld, whether they receive incme r nt. 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. Check the bx at right if the member des nt have any incme. B. Fill in each persns ttal incme and attach a cpy f the mst recent (2016) tax return - IRS Frm 1040 and all W-2 s/ 1099 s fr each husehld member where applicable. If there is n tax return, but the husehld member is emplyed, please state reasn fr n tax return. Yur applicatin may be denied if yu d nt prvide a cpy f the 2016 tax return and all W-2 s/1099 s fr each emplyed husehld member. C. Yu must cmplete a 4506-T Request fr Transcript f Tax Return Frm fr each wrking husehld member that cannt prvide a tax return. (1) Fill ut the Student ID line at the tp f the page. (2) Cmplete all items in Sectins 1 thrugh 4 as applicable. (3) Sign n the first signature line (nly ne signature is required); (4) date, (5) phne number. D. Skip t (6). (4) (5) CHILDREN S RACIAL AND ETHNIC IDENTITIES and All Kids Infrmatin Answer these questins if yu chse t. (6) SIGNATURE AND SOCIAL SECURITY NUMBER All Husehlds Cmplete This Part. A. All applicatins must have the signature f an adult husehld member. B. The adult signing the frm must als list the last fur numbers f his/her scial security number. C. If the adult des nt have a scial security number, mark the bx indicating "I d nt have a Scial Security number. D. A scial security number is nt required if yu are applying with a SNAP r TANF case number r if yu are applying fr a fster child. E. If there is n scial security number and the bx indicating such is nt checked, the applicatin will be denied. Privacy Act Statement: This explains hw we will use the infrmatin yu give us. 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, 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 adult husehld member wh signs the applicatin. The last fur digits f the scial security number is nt required when yu apply n behalf n 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. Nn-discriminatin Statement: This explains what t d if yu believe yu have been treated unfairly. In accrdance with Federal Law and U.S. Department f Agriculture plicy, this institutin is prhibited frm discriminating n the basis f race, clr, natinal rigin, sex, age, r disability. T file a cmplaint f discriminatin, write USDA, Directr, Office f Adjudicatin, 1400 Independence Avenue, SW, Washingtn, D.C r call tll free (866) (Vice). Individuals wh are hearing impaired r have speech disabilities may cntact USDA thrugh the Federal Relay Service at (800) , r (800) (Spanish). USDA is an equal pprtunity prvider and emplyer.

6 MAINE TOWNSHIP HIGH SCHOOL DISTRICT 207 Free/Reduced Price Meals and Fee Waiver Incme Eligibility Guidelines The United States Department f Agriculture has issued the fllwing incme guidelines fr the perid July 1, 2017, thrugh June 30, 2018: Husehld Size FREE Meals/Fee Waiver Annual Incme Mnthly Incme Twice Per Mnth Every 2 Weeks Weekly Incme Husehld Size REDUCED Price Meals/Fee Waiver Mnthly Twice Per Incme Mnth Annual Incme Every 2 Weeks Weekly Incme 1 $15,678 $1,307 $654 $603 $302 1 $22,311 $1,860 $930 $859 $ ,112 1, ,044 2,504 1,252 1, ,546 2,213 1,107 1, ,777 3,149 1,575 1, ,980 2,665 1,333 1, ,510 3,793 1,897 1, ,414 3,118 1,559 1, ,243 4,437 2,219 2,048 1, ,848 3,571 1,786 1, ,976 5,082 2,541 2,346 1, ,282 4,024 2,012 1, ,709 5,726 2,863 2,643 1, ,716 4,477 2,239 2,066 1, ,442 6,371 3,186 2,941 1,471 Fr each additinal family member, add: Fr each additinal family member, add: 5, , The fllwing is the definitin f incme: Incme is defined as any mnies earned befre any deductins such as incme taxes, scial security taxes, insurance premiums, charitable cntributins, and bnds. It includes the fllwing: Mnetary cmpensatin fr services including wages, salary, cmmissins, r fees; Net incme frm nn-farm self-emplyment; Net incme frm farm self-emplyment; Scial security; Dividends r interest n savings r bnds r incme frm estates r trusts; Net rental incme; Public assistance r welfare payments; Unemplyment cmpensatin; Gvernment civilian emplyee r military retirement r pensins r veteran payments; Private pensins r annuities; Alimny r child supprt payments; Regular cntributins frm persns nt living in the husehld; Net ryalties; Other cash incme - Other cash incme wuld include cash amunts received r withdrawn frm any surce including savings, investments, trust accunts, and ther resurces which wuld be available t pay the price f a child s meal.

7 Maine Twnship High Schl District FREE/REDUCED PRICE MEALS AND FEE WAIVER APPLICATION APPLYING FOR: Free/Reduced Price Meals Fee Waiver (1) APPLICANT INFORMATION Names f All Children in Schl First - Middle - Last Student ID# Fd Stamp r TANF Case Number (if any, per child). If yu list a SNAP r TANF Case Number, yu must attach a current cpy f IDHS Benefits Eligibility Letter with Case Number included, then Skip t (6) Check if Fster Child* (2) HOMELESS, MIGRANT, RUNAWAY r HEAD START (Categrically eligible) * Yu must attach a cpy f the frnt & back f the fster child s medical card. Hmeless Migrant Runaway Head Start Signature f Yur Schl Hmeless Liaisn, Migrant Crdinatr r Head Start Directr Date (3) TOTAL HOUSEHOLD GROSS INCOME - befre deductins Yu must tell us hw much and hw ften. NAME (List everyne in husehld) Scial Security Number (enter last 4 numbers) Date f Birth Ttal Incme frm IRS 2016 Frm 1040 Check If NO incme Attached is a cpy f the 2016 IRS Frm 1040 and all 1099 s and W-2 s fr each wrking husehld member. I did nt file IRS Frm 1040 because (4) CHILDREN S RACIAL AND ETHNIC IDENTITIES (Optinal) Mark ne ethnic identity: Mark ne r mre racial identities: Hispanic/Latin Asian Black r African American Nt Hispanic/Latin White American Indian r Alaska Native Native Hawaiian r Other Pacific Islander (5) Sharing Applicatin Infrmatin with All Kids All Kids is a cmplete healthcare prgram fr every child in Illinis. N! I DO NOT want infrmatin frm my Husehld Eligibility Applicatin shared with All Kids. Sign here (6) SIGNATURE AND SOCIAL SECURITY NUMBER (Adult must sign) An adult husehld member must sign the applicatin. The adult signing the frm must als list his/her scial security number r mark the I d nt have a scial security number bx. Scial Security Number: X X X - X X- I d nt have a scial security number. I certify (prmise) that all the infrmatin n this applicatin is true and that all husehld incme is reprted. I understand that the schl fficials may verify (check) the infrmatin. I understand that if I purpsely give false infrmatin, my children may lse benefits, and I may be prsecuted. / / Date Printed Name f Adult Husehld Member Signature f Adult Husehld Member Address f Adult Husehld Member City Zip Cde